Provider Demographics
NPI:1801160064
Name:DIAZ, DORSEY D (PSYD)
Entity type:Individual
Prefix:DR
First Name:DORSEY
Middle Name:D
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 1:1282 TOSCANA WAY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-8382
Mailing Address - Country:US
Mailing Address - Phone:775-430-2244
Mailing Address - Fax:
Practice Address - Street 1:502 E JOHN ST
Practice Address - Street 2:SUITE B
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3099
Practice Address - Country:US
Practice Address - Phone:775-434-7132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2016-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist