Individual
MELODY DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3924 RIVERVIEW DR, JURUPA VALLEY, CA 92509-6611
(951) 416-1572
Mailing address
3924 RIVERVIEW DR, JURUPA VALLEY, CA 92509-6611
(951) 416-1572
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
MPSS-HYIRTF
CA
Other
Enumeration date
07/08/2021
Last updated
07/10/2023
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