Provider Demographics
NPI:1750779492
Name:DIAZ, ARTURO JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:ARTURO
Middle Name:
Last Name:DIAZ
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S REDWOOD AVE APT A
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-8518
Mailing Address - Country:US
Mailing Address - Phone:714-328-1589
Mailing Address - Fax:
Practice Address - Street 1:3151 AIRWAY AVE STE F107
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4623
Practice Address - Country:US
Practice Address - Phone:714-328-1589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA289721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical