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NPI Code Detail

MEDICARE: ELIZABETH DIAZ ASW

MEDICARE: ELIZABETH DIAZ ASW
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
1101YM0800XMental Health CounselorASW101053CA
2171M00000XCase Manager/Care CoordinatorCA
31041C0700XClinical Social WorkerASW101053CA
4171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1558911958
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH DIAZ ASW
Provider Business Mailing Address
First Line : 177 W HENDERSON AVE STE 1
Second Line :
City : PORTERVILLE
State : CA
Zip : 93257-1777
Country : US
Telephone Number : 559-784-0312
Fax Number :
Provider Business Practice Location Address
First Line : 177 W HENDERSON AVE STE 1
Second Line :
City : PORTERVILLE
State : CA
Zip : 93257-1777
Country : US
Telephone Number : 559-719-8233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2019
Last Update Date : 10/04/2023

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