Malina Celine Diaz | Stockton, CA • PECOS Search

Malina Celine Diaz

Counselor

Behavioral Health & Social Service Providers

1414 N California St, Stockton, CA 95202-1515

PECOS Enrollment

Based on the most recent information from CMS, provider Malina Celine Diaz does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1568938124
Provider Type
Individual
Full Name
Diaz, Malina Celine
Gender
Female

Sole Proprietor
No
Enumeration Date
10/22/2018
Last Updated
10/22/2018

Contact Information

Practice Location

1414 N California St, Stockton, CA 95202-1515

Unlisted Fax

Mailing Location

1414 N California St, Stockton, CA 95202-1515

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer