Dominique A Diaz
Behavior Technician in Modesto, CA. Individual provider (NPI-1).
NPI number1124612866
StatusActive
Last updated in NPPESFeb 23, 2021
Details
- NPI
- 1124612866
- Entity type
- Individual (NPI-1)
- Name
- Dominique A Diaz
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 23, 2021
- Certification date
- Feb 23, 2021
- Last updated
- Feb 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1317 Oakdale Rd Ste 610Modesto, CA 95355-3365
Phone 855-581-0100
Mailing address
2080 N Tustin Ave Ste BSanta Ana, CA 92705-7875
Phone 855-581-0100
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