Jorge Luis Diaz
Day Training/Habilitation Specialist in Santa Monica, CA. Individual provider (NPI-1).
NPI number1073122107
StatusActive
Last updated in NPPESApr 16, 2025
Details
- NPI
- 1073122107
- Entity type
- Individual (NPI-1)
- Name
- Jorge Luis Diaz
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 24, 2020
- Certification date
- Apr 16, 2025
- Last updated
- Apr 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | CA | |
| 172V00000X | Community Health Worker | – | – | |
| 101Y00000X | Counselor | – | – |
Practice location
1328 2nd StSanta Monica, CA 90401-1122
Phone 310-394-6889
Mailing address
1328 2nd StSanta Monica, CA 90401-1122
Phone 310-394-6889
Other practice locations
290 N D St Ste 700
San Bernardino, CA 92401-1705
San Bernardino, CA 92401-1705
Phone 909-963-5355
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