Individual
MRS. GISELLE DIAZ REA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S
Contact information
Practice address
6161 FAIRMOUNT AVE APT 517, SAN DIEGO, CA 92120-3672
(847) 809-1951
Mailing address
6161 FAIRMOUNT AVE APT 517, SAN DIEGO, CA 92120-3672
(847) 809-1951
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
240234923
CA
103TS0200X
School Psychologist
2677440
IL
103TS0200X
School Psychologist
SP0000001211679
MI
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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