Provider Demographics
NPI:1801685490
Name:DIETRICH, ALEECE CHRISTINA CAZAN
Entity type:Individual
Prefix:
First Name:ALEECE
Middle Name:CHRISTINA CAZAN
Last Name:DIETRICH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25676 HURON ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3704
Mailing Address - Country:US
Mailing Address - Phone:509-981-7259
Mailing Address - Fax:
Practice Address - Street 1:11234 ANDERSON ST OFC UA-202
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-1716
Practice Address - Country:US
Practice Address - Phone:909-651-5510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program