Provider Demographics
NPI:1265565675
Name:DIAZ, FRANCES STEPHANIE LOPEZ (PSYD)
Entity type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:STEPHANIE LOPEZ
Last Name:DIAZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3307
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-3307
Mailing Address - Country:US
Mailing Address - Phone:310-825-6692
Mailing Address - Fax:310-794-4996
Practice Address - Street 1:1000 VETERAN AVE
Practice Address - Street 2:BOX 957142
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7142
Practice Address - Country:US
Practice Address - Phone:310-825-6692
Practice Address - Fax:310-794-4996
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21313103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical