Provider Demographics
NPI:1033924097
Name:DIAZ, BRITNEY GIENELLE (BACHELOR'S)
Entity type:Individual
Prefix:MISS
First Name:BRITNEY
Middle Name:GIENELLE
Last Name:DIAZ
Suffix:
Gender:X
Credentials:BACHELOR'S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43815 12TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4729
Mailing Address - Country:US
Mailing Address - Phone:661-434-3536
Mailing Address - Fax:
Practice Address - Street 1:43815 12TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4729
Practice Address - Country:US
Practice Address - Phone:661-434-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician