Provider Demographics
NPI:1124687306
Name:DIAZ-BARRERA, DANIELA
Entity type:Individual
Prefix:MS
First Name:DANIELA
Middle Name:
Last Name:DIAZ-BARRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29325 KIMBERLINA RD
Mailing Address - Street 2:
Mailing Address - City:WASCO
Mailing Address - State:CA
Mailing Address - Zip Code:93280-7617
Mailing Address - Country:US
Mailing Address - Phone:661-758-4029
Mailing Address - Fax:661-758-0891
Practice Address - Street 1:29341 KIMBERLINA RD STE 102
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-7617
Practice Address - Country:US
Practice Address - Phone:661-758-4029
Practice Address - Fax:661-758-0891
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator