Carmen Lisandra Diaz | San Ramon, CA • PECOS Search

Carmen Lisandra Diaz

Behavior Technician

Behavioral Health & Social Service Providers

2010 Crow Canyon Pl Ste 100, San Ramon, CA 94583-1344

PECOS Enrollment

Based on the most recent information from CMS, provider Carmen Lisandra 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 2 days ago.

Profile Details

Provider ID
1992508428
Provider Type
Individual
Full Name
Diaz, Carmen Lisandra
Title
Mrs.

Gender
Female
Sole Proprietor
No
Enumeration Date
3/31/2025
Last Updated
3/31/2025

Contact Information

Practice Location

2010 Crow Canyon Pl Ste 100, San Ramon, CA 94583-1344

Unlisted Fax

Mailing Location

7108 S Kanner Hwy, Stuart, FL 34997-7462

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer