Individual
JACQUELYNN J DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6646 SAHARA AVE, TWENTYNINE PALMS, CA 92277-3639
(626) 788-7935
Mailing address
6646 SAHARA AVE, TWENTYNINE PALMS, CA 92277-3639
(626) 788-7935
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XX
CA
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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