Active NPI
Krystal Desiree Diaz
- Mental Health Counselor
- Pasadena, CA
National Provider Identifier
1245664093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW63826
- Practice address
- 36 S Kinneloa Ave Ste 100
Pasadena, CA 91107-3853 - Phone
- (323) 844-3033
- NPI assigned
- Aug 29, 2013
- Last updated
- Oct 5, 2016
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW63826 | CA | Primary |
Addresses
Primary practice location
36 S Kinneloa Ave Ste 100
Pasadena, CA 91107-3853
Mailing address
4617 Yellowstone St
Los Angeles, CA 90032-3746
Phone (323) 382-4856
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 |
|---|---|---|---|
| ASW63826 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475625600000",
"number": "1245664093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4617 YELLOWSTONE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900323746",
"telephone_number": "323-382-4856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 S KINNELOA AVE STE 100",
"city": "PASADENA",
"state": "CA",
"postal_code": "911073853",
"telephone_number": "323-844-3033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "KRYSTAL",
"middle_name": "DESIREE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-29",
"last_updated": "2016-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW63826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.