Martha Alicia Diaz

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

Practice address

16756 Chino Corona Rd
Eastvale, CA 92880-9508

Phone

(909) 597-1771

NPI assigned

May 15, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Corrections and Rehabilitation-Headquarters

  dba California Institution for Women

  • Pharmacy
  • Corona, CA
  • NPI 1578199741
  NPD
• State of California

  • Psychiatric Hospital
  • Corona, CA
  • NPI 1366783169
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1073135703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23959 COUGAS CREEK RD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16756 CHINO CORONA RD",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928809508",
            "telephone_number": "909-597-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "MARTHA",
        "middle_name": "ALICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Robert Dewoskin, PHARM.D.
• Mrinal Dhar, MD
• Dhruv Physician Assistant
• Evelyn P Diaz, BA
• Mardy Lindt Fionne Diaz
• Blaise Njieya Djeugoue, FNP
• Quang DO, DC
• Peter Dung-Quoc Doan, MD
• Arvin John Liwag Domingo
• Robert Anthony Dominguez, MSW, LCSW

• Licensed Psychiatric Technician in Eastvale, CA
• Providers in Eastvale, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.