Individual
FELIPE DE JESUS DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSSI
Contact information
Practice address
771 W BLAINE ST STE D, RIVERSIDE, CA 92507-3940
(951) 470-5214
Mailing address
771 W BLAINE ST, RIVERSIDE, CA 92507-3940
(951) 470-5214
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
04/22/2014
Last updated
12/07/2022
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