Individual
JESSICA MICHELLE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3850 CRENSHAW BLVD, LOS ANGELES, CA 90008-1821
(323) 593-5300
Mailing address
3850 CRENSHAW BLVD, LOS ANGELES, CA 90008-1821
(323) 593-5300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1327221118
CA
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
11/05/2018
Last updated
01/27/2026
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