Provider Demographics
NPI:1457586174
Name:DIAZ, MERIDA (LVN)
Entity type:Individual
Prefix:MS
First Name:MERIDA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8427 S CORTO AVE
Mailing Address - Street 2:8427 S CORTO
Mailing Address - City:PARLIER
Mailing Address - State:CA
Mailing Address - Zip Code:93648-2701
Mailing Address - Country:US
Mailing Address - Phone:559-892-6239
Mailing Address - Fax:
Practice Address - Street 1:8427 S CORTO AVE
Practice Address - Street 2:8427 S CORTO
Practice Address - City:PARLIER
Practice Address - State:CA
Practice Address - Zip Code:93648-2701
Practice Address - Country:US
Practice Address - Phone:559-892-6239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN236393164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse