Active NPI
Jacqueline Monique Diaz, FNP
- Family Nurse Practitioner
- Temecula, CA
National Provider Identifier
1104756691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95039624
- Practice address
- 27450 Ynez Rd Ste 128
Temecula, CA 92591-4680 - Phone
- (951) 331-4020
- NPI assigned
- May 19, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95039624 | CA | Primary |
Addresses
Primary practice location
27450 Ynez Rd Ste 128
Temecula, CA 92591-4680
Mailing address
27450 Ynez Rd Ste 128
Temecula, CA 92591-4680
Phone (951) 331-4020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95039624 | CA | MD | Family Nurse Practitioner |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DCHGDD/Endpoint/DCHGDD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779148800000",
"number": "1104756691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27450 YNEZ RD STE 128",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925914680",
"telephone_number": "951-331-4020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27450 YNEZ RD STE 128",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925914680",
"telephone_number": "951-331-4020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "JACQUELINE",
"middle_name": "MONIQUE",
"name_prefix": "Miss",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-19",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95039624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.