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1356844690
JALISA DIAZ
TRACY, CA
NPI
1356844690
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA 18-49654)
Enumeration Date
2018-03-13
Last Update Date
2018-03-13
Business Address
JALISA DIAZ
510 WHISPERING WIND DR STE 110
TRACY, CA 95377-8119
Phone number: 209-572-2589
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Mailing Address
JALISA DIAZ
PO BOX 5157
MODESTO, CA 95352-5157
Phone number: 209-572-2589
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