Provider Demographics
NPI:1891204814
Name:CHICA, DIANA RUBI
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:RUBI
Last Name:CHICA
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 1:699 WINSLOW DR
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-1916
Mailing Address - Country:US
Mailing Address - Phone:530-218-3085
Mailing Address - Fax:
Practice Address - Street 1:699 WINSLOW DR
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-1916
Practice Address - Country:US
Practice Address - Phone:530-218-3085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician