Provider Demographics
NPI:1306343983
Name:DIAZ, DEBORAH (DOCTOR OF CHIROPRACT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 CASS ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2904
Mailing Address - Country:US
Mailing Address - Phone:831-595-4952
Mailing Address - Fax:
Practice Address - Street 1:829 CASS ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2904
Practice Address - Country:US
Practice Address - Phone:831-595-4951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor