Provider Demographics
NPI:1245373273
Name:DIAZ, YINA ELIZABET (PHD)
Entity type:Individual
Prefix:DR
First Name:YINA
Middle Name:ELIZABET
Last Name:DIAZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE ACUARELA #10 COND. QUINTA VALLE TORRE NORTE APT.
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-983-2383
Mailing Address - Fax:
Practice Address - Street 1:CALLE ACUARELA #10 COND. QUINTA VALLE TORRE NORTE
Practice Address - Street 2:APARTMENT 903
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-983-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR57156103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical