Individual
ANGELICA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
947 S ANAHEIM BLVD, SUITE 270, ANAHEIM, CA 92805-5582
(714) 535-1415
(714) 635-6771
Mailing address
1924 W BAKER AVE, FULLERTON, CA 92833-4414
(714) 535-1415
(714) 635-6771
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
FP-C 15085
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F1104107
AAOFNP CERTIFICATE NUMBER
CA
05
—
GR0090750
—
CA
01
—
NP 15085
CA NURSE PRACTITIONER #
CA
Enumeration date
10/18/2006
Last updated
03/07/2023
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