Individual
MR. JOHN ANTHONY DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
456 ELM AVE, LONG BEACH, CA 90802-2426
(562) 437-6717
(562) 437-5072
Mailing address
456 ELM AVE, LONG BEACH, CA 90802-2426
(562) 437-6717
(562) 437-5072
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
698617
CA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
698617
CA
171M00000X
Case Manager/Care Coordinator
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
03/27/2007
Last updated
01/06/2014
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