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NPI Code Detail

MEDICARE: ALISON KEMPTER DIAZ LCSW

MEDICARE:   ALISON  KEMPTER DIAZ  LCSW
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1518540061
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISON KEMPTER DIAZ LCSW
Provider Business Mailing Address
First Line : 1325 IRIS AVE
Second Line :
City : IMPERIAL BEACH
State : CA
Zip : 91932-3751
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1325 IRIS AVE
Second Line :
City : IMPERIAL BEACH
State : CA
Zip : 91932-3751
Country : US
Telephone Number : 619-429-2532
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2021
Last Update Date : 05/03/2021

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Directions to “ ALISON KEMPTER DIAZ LCSW” Practice Location

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