Individual
GISELE KIANA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APCC
Contact information
Practice address
5348 UNIVERSITY AVE STE 108, SAN DIEGO, CA 92105-8025
(619) 255-9278
Mailing address
5348 UNIVERSITY AVE STE 108, SAN DIEGO, CA 92105-8025
(619) 255-9278
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPCC14775
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7162086
—
CA
Enumeration date
08/30/2022
Last updated
10/05/2023
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