Jessica Lynn Diaz, CDAC-R

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Medford, OR

NPI 1720964844 · NPPES record last updated Aug 13, 2025

Key facts

NPI
1720964844
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
300 W Main St
Medford, OR 97501-2756
Phone
(541) 772-1777
NPI assigned
Aug 13, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

300 W Main St
Medford, OR 97501-2756

Mailing address

300 W Main St
Medford, OR 97501-2756
Phone (541) 772-1777

Other providers in Medford, OR

All providers in Medford, OR · Addiction (Substance Use Disorder) Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.