Individual provider Active NPI

Daniel Jose Diaz

  • Counselor
  • Riverside, CA
National Provider Identifier
1649713108
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
8876 Mission Blvd
Riverside, CA 92509-2811
Phone
(951) 955-0958
NPI assigned
Nov 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X R1473460622 CA
Case Manager/Care Coordinator 171M00000X
Counselor 101Y00000X Primary

Addresses

Primary practice location

8876 Mission Blvd
Riverside, CA 92509-2811

Mailing address

8876 Mission Blvd
Riverside, CA 92509-2811
Phone (951) 955-0958

Other practice location 1

771 W Blaine St Ste C
Riverside, CA 92507-3940
Phone (951) 955-2233

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

LicenseStateTypeSpecialty
R1473460622CAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1649713108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8876 MISSION BLVD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925092811",
            "telephone_number": "951-955-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8876 MISSION BLVD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925092811",
            "telephone_number": "951-955-0958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "771 W Blaine St Ste C",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925073940",
            "country_code": "US",
            "telephone_number": "951-955-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "DANIEL",
        "middle_name": "JOSE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-30",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "R1473460622",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.