Basic Information
| Provider Information | |||||||||
| NPI: | 1093207953 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUNOZ | ||||||||
| FirstName: | DIANA | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1016 N BRADFORD AVE | ||||||||
| Address2: | |||||||||
| City: | PLACENTIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928704302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597378900 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 501 N BROOKHURST ST | ||||||||
| Address2: | STE 320 | ||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928015204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144907711 | ||||||||
| FaxNumber: | 7144907717 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2018 | ||||||||
| LastUpdateDate: | 06/05/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.