Individual
CHRISTINE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2033 S CRESCENT AVE, SAN PEDRO, CA 90731-5512
(310) 519-8723
Mailing address
270 W 14TH ST, SAN PEDRO, CA 90731-4396
(310) 519-8723
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1456830122
CA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/31/2022
Last updated
04/25/2022
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