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Jalisa Diaz

Behavior Technician in Tracy, CA. Individual provider (NPI-1).

NPI number1356844690
StatusActive
Last updated in NPPESMar 13, 2018

Details

NPI
1356844690
Entity type
Individual (NPI-1)
Name
Jalisa Diaz
Sex
Female
Sole proprietor
No
Enumeration date
Mar 13, 2018
Last updated
Mar 13, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician18-49654CAYes

Practice location

510 Whispering Wind Dr Ste 110
Tracy, CA 95377-8119

Phone 209-572-2589 · Fax 209-572-1461

Mailing address

Po Box 5157
Modesto, CA 95352-5157

Phone 209-572-2589 · Fax 209-572-1461

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