Individual
AVIELA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44443 10TH ST W, LANCASTER, CA 93534-3346
(818) 996-1051
Mailing address
44443 10TH ST W, LANCASTER, CA 93534-3346
(661) 726-2630
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#95-2633765
MEDI-CAL
CA
Enumeration date
06/09/2015
Last updated
04/30/2025
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