| Doctor Name: | NILDA DIAZ |
| NPI Number: | 1225267172 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | PSY 22640 |
| Business Practice Address: | 3102 E. Highland Avenue Medical Staff Office Patton, CA - 92369 |
| Business Phone Number: | 9094257679 |
| Business Fax Number: | 9094256635 |
| Mailing Address: | 3102 E. Highland Avenue, Medical Staff Office PATTON |
| State: | CA |
| Postal Code: | 92369 |
| Phone Number: | 9094257679 |
| Fax Number: | 9094256635 |
| NPI Enumeration Date: | 07/13/2009 |
| NPI Last Update Date: | 03/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 22640 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |