Individual
MARIA TERESA DIAZ RODARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44199 MONROE ST STE B, INDIO, CA 92201-3094
(760) 863-7099
Mailing address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(951) 955-7161
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-VIGLUJ
CA
Other
Enumeration date
01/21/2022
Last updated
01/08/2024
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