Active NPI
Brenda Maria Diaz, M.S., MFT INTERN
- Marriage & Family Therapist
- Covina, CA
National Provider Identifier
1477756690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT99479
- Practice address
- 1126 N Grand Ave
Suite D
Covina, CA 91724-1551 - Phone
- (619) 436-8268
- NPI assigned
- Jun 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT99479 | CA | Primary |
Addresses
Primary practice location
1126 N Grand Ave
Suite D
Covina, CA 91724-1551
Mailing address
1126 N Grand Ave
Suite D
Covina, CA 91724-1551
Phone (619) 436-8268
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT99479 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493942400000",
"number": "1477756690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1126 N GRAND AVE",
"address_2": "SUITE D",
"city": "COVINA",
"state": "CA",
"postal_code": "917241551",
"telephone_number": "619-436-8268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 N GRAND AVE",
"address_2": "SUITE D",
"city": "COVINA",
"state": "CA",
"postal_code": "917241551",
"telephone_number": "619-436-8268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "BRENDA",
"middle_name": "MARIA",
"name_prefix": "Miss",
"credential": "M.S., MFT INTERN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-06",
"last_updated": "2017-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT99479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.