Individual
CRYSTAL DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 W BADILLO ST, COVINA, CA 91722-3787
(626) 993-3000
Mailing address
530 W BADILLO ST, COVINA, CA 91722-3787
(626) 993-3000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
10342
CA
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2020
Last updated
09/22/2021
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