Individual
JUDITH DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1001 NEEDHAM ST, MODESTO, CA 95354-0730
(209) 569-0373
Mailing address
1001 NEEDHAM ST, MODESTO, CA 95354-0730
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-RTPZJF
CA
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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