Individual
DR. SANDRA E DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
500 FOOTHILL DR, 116/OP, SALT LAKE CITY, UT 84148-0001
(909) 267-5238
Mailing address
500 FOOTHILL DR, 116/OP, SALT LAKE CITY, UT 84148-0001
(909) 267-5238
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9688868-2501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11705929
CAQH
CA
Enumeration date
11/21/2006
Last updated
08/01/2016
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