Diaz, Selena Marie

Diaz, Selena Marie is an individual health care provider with primary practice located at 15350 Nordhoff St Ste A , North Hills CA 91343-2234. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. Diaz, Selena Marie can be contacted via phone (818) 672-8228.

Contact Information

Primary practice address
15350 Nordhoff St Ste A North Hills CA 91343-2234
Phone: (818) 672-8228
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Assistant 126800000X 67509 California

Profile Details

NPI number 1639629157
LBN Legal business name Diaz, Selena Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2016
Last updated Oct 7th, 2016 - about 8 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1639629157 NPPES
California MEDICAID 67509

Popular Providers