Diaz, Alexa Marie

Diaz, Alexa Marie is an individual health care provider with primary practice located at 635 East Baseline Road , Phoenix AZ 85042-6551. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutritionist, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Diaz, Alexa Marie can be contacted via phone (602) 243-7277.

Contact Information

Primary practice address
635 East Baseline Road Phoenix AZ 85042-6551
Phone: (602) 243-7277
Fax: (602) 243-1235
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 86002413 Arizona

Profile Details

NPI number 1922376193
LBN Legal business name Diaz, Alexa Marie
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2011
Last updated Oct 12th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922376193 NPPES
Arizona MEDICAID 701269

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