Active NPI
Maia Ilana Driz Diaz
- Behavior Analyst
- Gardena, CA
National Provider Identifier
1124802541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- Y4410358
- Practice address
- 1411 W 190TH St
Gardena, CA 90248-4324 - Phone
- (310) 719-3908
- NPI assigned
- Aug 24, 2023
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Y4410358 | CA | Primary |
Addresses
Primary practice location
1411 W 190TH St
Gardena, CA 90248-4324
Mailing address
1993 E Woodlyn Rd
Pasadena, CA 91104-3331
Phone (626) 340-3318
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Y4410358 | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692835200000",
"number": "1124802541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1993 E WOODLYN RD",
"city": "PASADENA",
"state": "CA",
"postal_code": "911043331",
"telephone_number": "626-340-3318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 W 190TH ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902484324",
"telephone_number": "310-719-3908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "MAIA ILANA",
"middle_name": "DRIZ",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-24",
"last_updated": "2023-08-24",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "Y4410358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.