Diaz, Audrea A
Diaz, Audrea A is an individual health care provider with primary practice located at 1323 W Colton Ave Ste 100 , Redlands CA 92374-2853. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Diaz, Audrea A can be contacted via phone (909) 335-7067.Contact Information
Primary practice address
1323 W Colton Ave Ste 100
Redlands CA 92374-2853
Phone: (909) 335-7067
Fax: (909) 792-2045
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | RW0772 | California |
Profile Details
| NPI number | 1275744674 |
|---|---|
| LBN Legal business name | Diaz, Audrea A |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275744674 | NPPES |
| California | Other | 4739 | SIMON STAFF NUMBER |
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