MEDICARE: FAVIOLA DIAZ LMFT

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	106H00000X	Marriage & Family Therapist	134208	CA
2	106H00000X	Marriage & Family Therapist	205768	TX

General Provider Information

NPI Number	:	1821572769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAVIOLA DIAZ LMFT

Provider Business Mailing Address
First Line	:	7813 AREZZO DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-4531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9300 RESEARCH BLVD STE 205
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-7494
Country	:	US
Telephone Number	:	210-399-3252
Fax Number	:

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

Provider Enumeration Date	:	09/17/2018
Last Update Date	:	08/08/2025

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Directions to “ FAVIOLA DIAZ LMFT” Practice Location

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