Individual
MS. AIDE DIAZ-IBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
1000 GOODRICH BLVD # 114, COMMERCE, CA 90022-5103
(323) 832-9795
Mailing address
10415 PARAMOUNT BLVD APT 114, DOWNEY, CA 90241-2382
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ENK 1808
L.A DEPT OF MENTAL HEALTH
CA
Enumeration date
03/08/2007
Last updated
07/08/2007
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