Basic Information
| Provider Information | |||||||||
| NPI: | 1669773156 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OROZCO | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | CAROLINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12625 HEACOCK ST | ||||||||
| Address2: | |||||||||
| City: | MORENO VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925530538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9514867945 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4295 BROCKTON AVE | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925013446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9513413786 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2010 | ||||||||
| LastUpdateDate: | 05/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.