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NPI Code Detail

MEDICARE: SERGIO E. DIAZ

MEDICARE: SERGIO E. DIAZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorSUDRC11444CA

General Provider Information

NPI Number : 1376499913
Entity Type Code : Individual
Provider Name (Legal Business Name) : SERGIO E. DIAZ
Provider Business Mailing Address
First Line : 225 GRANDVIEW ST
Second Line :
City : PASADENA
State : CA
Zip : 91104-2114
Country : US
Telephone Number : 626-797-1124
Fax Number :
Provider Business Practice Location Address
First Line : 225 GRANDVIEW ST
Second Line :
City : PASADENA
State : CA
Zip : 91104-2114
Country : US
Telephone Number : 626-797-1124
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2026
Last Update Date : 03/06/2026

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Directions to “ SERGIO E. DIAZ ” Practice Location

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