MEDICARE: PENELOPE 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
1	101YM0800X	Mental Health Counselor	87439	TX

General Provider Information

NPI Number	:	1720858517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PENELOPE DIAZ

Provider Business Mailing Address
First Line	:	14027 JOPLIN TER
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-4483
Country	:	US
Telephone Number	:	210-877-4895
Fax Number	:

Provider Business Practice Location Address
First Line	:	14027 JOPLIN TER
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-4483
Country	:	US
Telephone Number	:	210-877-4895
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2024
Last Update Date	:	01/03/2024

Similar Medicare Providers

1871488171 — HERO SHUTTLE LLC
Practice Location Address:

7147 POLO DOWNS
SAN ANTONIO, TX
78218-4483

Practice Phone: 210-956-0610
Practice Fax:

1487546206 — BLBLOOMCARE, INC
Practice Location Address:

12117 MERRITT VILLA
SAN ANTONIO, TX
78253-4483

Practice Phone: 832-614-1323
Practice Fax:

1124378369 — DR. DIANA A PAULINO RIVERA PHARM D.
Practice Location Address:

150 CALLE F VIZCARRONDO
SAN JUAN, PR
00926-4483

Practice Phone: 787-755-1375
Practice Fax: 787-755-1340

1407258890 — DR. CAROLINA LEBRON
Practice Location Address:

150 CALLE F VIZCARRONDO
SAN JUAN, PR
00926-4483

Practice Phone: 787-755-1375
Practice Fax:

1275092744 — DR. NYNOSHKA MARIE MORENO QUILES PHARMD.
Practice Location Address:

150 CALLE F VIZCARRONDO
SAN JUAN, PR
00926-4483

Practice Phone: 787-755-1375
Practice Fax:

1093353617 — NICOLE MEDINA PHARMD
Practice Location Address:

150 CALLE F VIZCARRONDO
SAN JUAN, PR
00926-4483

Practice Phone: 787-755-1375
Practice Fax:

Directions to “ PENELOPE DIAZ ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.