Provider Demographics
NPI:1710342167
Name:DIAZ, HANNA (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:HANNA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:HANNA
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APCC
Mailing Address - Street 1:212 CARMEN LN STE 201
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7771
Mailing Address - Country:US
Mailing Address - Phone:805-212-7680
Mailing Address - Fax:805-728-9492
Practice Address - Street 1:212 CARMEN LN STE 201
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-7771
Practice Address - Country:US
Practice Address - Phone:805-212-7680
Practice Address - Fax:805-728-9492
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 1041C0700X, 171M00000X
CA12724101YM0800X
CA5818253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No253J00000XAgenciesFoster Care Agency