Fredy Jesus Diaz

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

PO Box 6609
Big Bear Lake, CA 92315-6609

Phone

(909) 878-2326

NPI assigned

Nov 26, 2024

Last updated

Dec 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Mom & Dad Project

  • Case Management Agency
  • Big Bear Lake, CA
  • NPI 1962262097
  NPD

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1083430854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 SIERRA AVE",
            "city": "BIG BEAR CITY",
            "state": "CA",
            "postal_code": "923149779",
            "telephone_number": "909-521-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 6609",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "923156609",
            "telephone_number": "909-878-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "FREDY",
        "middle_name": "JESUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-26",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-HFEGQM",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Horner PC
• Jamie Davidson, DNP
• Brett Davis, P.A.
• Kimberly Brooke Delandtsheer
• Benjamin Warren Delanty, MSW
• Dawn Dopps
• Dr James W Almaraz O D Inc
• Dr. Eric a. Saidi, O.D., Inc.
• Kaitlin Rose Duskin
• Monica Dwyer

• Community Health Worker in Big Bear Lake, CA
• Providers in Big Bear Lake, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.