Michelle Diaz, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95013258 Issued in CA

Practice address

5525 Grossmont Center Dr Ste 602
La Mesa, CA 91942-3009

Phone

(619) 740-4770

NPI assigned

May 27, 2021

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

State licenses

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1093381444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 GROSSMONT CENTER DR STE 602",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423009",
            "telephone_number": "619-740-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 GROSSMONT CENTER DR STE 602",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423009",
            "telephone_number": "619-740-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-07-02",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95013258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diamond Orthotic Laboratory
• Diamond Surgical Suites LLC
• Ashley Raquel Diaz I
• Hector Diaz Jr., IDC
• Jose Cruz Diaz Jr.
• Phillip Dickinson, M.D.
• David Russell Diehl, MD
• Khoi Diep
• Eileen Oliver Dimapilis, DMD
• Judemar Saculinggan Dimapilis, DMD

• Nurse Practitioner in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.