Individual provider Active NPI

Alyssa Diaz

  • Counselor
  • Moreno Valley, CA
National Provider Identifier
1609356955
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
10307 Issued in CA
Practice address
13800 Heacock St Ste C220
Moreno Valley, CA 92553-3363
Phone
(951) 653-1800
NPI assigned
Aug 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X APCC10307 CA
Professional Counselor 101YP2500X APCC10307 CA
Counselor 101Y00000X 10307 CA Primary

Addresses

Primary practice location

13800 Heacock St Ste C220
Moreno Valley, CA 92553-3363

Mailing address

13800 Heacock St Ste C220
Moreno Valley, CA 92553-3363
Phone (951) 653-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814002540 CA Practitioner - Mental Health Counselor 3274032651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1275 W Park Ave
Suite 7461
Redlands, CA 92373-8111

13014 W Greenfield Rd
Nine Mile Falls, WA 99026-9361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APCC10307CAMDProfessional Counselor
10307CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spring to Autumn Family Counseling, Inc. CurrentSince Jul 31, 2025 Accepting new patients
Special Service for Groups, Inc. CurrentSince Jun 12, 2022 Accepting new patients

Locations

13800 Heacock St
Ste C220
Moreno Valley, CA 92553
Phone (951) 243-4192

2068 Orange Tree Ln
Ste 216
Redlands, CA 92374
Phone (909) 553-0448

1275 W Park Ave
#7461
Redlands, CA 92373

11870 Pierce St
Ste 150
Riverside, CA 92505
Phone (909) 557-6574

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1609356955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 HEACOCK ST STE C220",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533363",
            "telephone_number": "951-653-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 HEACOCK ST STE C220",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533363",
            "telephone_number": "951-653-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "APCC10307",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "APCC10307",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "10307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.