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Individual
JESSICA LISBET DIAZ
Active
Individual
JESSICA LISBET DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW97835
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ASW67504
CA
101YM0800X
Mental Health Counselor
LCSW97835
—
1041C0700X
Clinical Social Worker
Primary
LCSW97835
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/15/2014
Last updated
05/19/2021
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