Individual
ALYSSA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13800 HEACOCK ST STE C220, MORENO VALLEY, CA 92553-3363
(951) 653-1800
Mailing address
13800 HEACOCK ST STE C220, MORENO VALLEY, CA 92553-3363
(951) 653-1800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
10307
CA
101YM0800X
Mental Health Counselor
APCC10307
CA
101YP2500X
Professional Counselor
APCC10307
CA
Other
Enumeration date
08/16/2018
Last updated
10/02/2024
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