Jackie E Diaz, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

213510 Issued in CA

Practice address

5202 University Ave
Central Region Public Health Center
San Diego, CA 92105-2268

Phone

(619) 229-5400

NPI assigned

May 3, 2010

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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1295052090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 ALAMITOS WAY",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920786158",
            "telephone_number": "760-727-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 UNIVERSITY AVE",
            "address_2": "CENTRAL REGION PUBLIC HEALTH CENTER",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921052268",
            "telephone_number": "619-229-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JACKIE",
        "middle_name": "E",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-03",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "213510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrison Elias Diaz, MD
• Heather Diaz, BCBA
• Hillary Diaz
• Ian Diaz, MD
• Isaac Diaz
• Jaenai Diaz, LCSW
• Jeanne Diaz
• Jessica Diaz
• Jessica Michelle Diaz
• Jose A Diaz

• Licensed Vocational Nurse in San Diego, CA
• Providers in San Diego, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.