Individual
MARTHA ALICIA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16756 CHINO CORONA RD, EASTVALE, CA 92880-9508
(909) 597-1771
Mailing address
23959 COUGAS CREEK RD, DIAMOND BAR, CA 91765-1104
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
—
CA
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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