Active NPI
Alyssa Diaz
- Physical Therapy Assistant
- San Bernardino, CA
National Provider Identifier
1346633054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 10366
- Practice address
- 1955 Hunts LN
San Bernardino, CA 92408-3347 - Phone
- (909) 890-9030
- NPI assigned
- Mar 5, 2015
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 10366 | CA | Primary |
Addresses
Primary practice location
1955 Hunts LN
San Bernardino, CA 92408-3347
Mailing address
6717 Catalina Dr
Riverside, CA 92504-1814
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425513600000",
"number": "1346633054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6717 CATALINA DR",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925041814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1955 HUNTS LN",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083347",
"telephone_number": "909-890-9030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-05",
"last_updated": "2015-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "10366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.