Individual
CONNIE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32130 HEMPLE ST, WILDOMAR, CA 92595-8380
(951) 217-5374
Mailing address
32130 HEMPLE ST, WILDOMAR, CA 92595-8380
(951) 217-5374
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
716634
CA
Other
Enumeration date
09/12/2016
Last updated
01/02/2026
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