Provider Demographics
NPI:1477319234
Name:DIAZ, SABRINA MARIE (DC)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:MARIE
Last Name:DIAZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4916
Mailing Address - Country:US
Mailing Address - Phone:707-235-0027
Mailing Address - Fax:
Practice Address - Street 1:122 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5715
Practice Address - Country:US
Practice Address - Phone:617-441-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACHI3855111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor