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Jake Diaz
Mental Health Counselor in South Lake Tahoe, California
NPI 1629583802

Jake Diaz is a Mental Health Counselor based in South Lake Tahoe, CA and is specialized in Mental Health. Jake Diaz practices in South Lake Tahoe, CA. The NPI Number for Jake Diaz is 1629583802 and holds a License No. (California).

The current practice location address for Jake Diaz is 1900 Lake Tahoe Blvd, South Lake Tahoe, CA and can be reached out via phone at 530-573-7970.

Location: 1900 Lake Tahoe Blvd, South Lake Tahoe, CA, 96150-6305
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629583802
Provider Name
Jake Diaz
Credential
Provider Entity Type
Individual
Gender
Male
Address
1900 Lake Tahoe Blvd, South Lake Tahoe, CA, 96150-6305
Phone Number
530-573-7970
Fax Number
Provider Enumeration Date
12/09/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1900 Lake Tahoe Blvd
City
South Lake Tahoe
State
California
Zip
96150-6305
Phone Number
530-573-7970
Fax Number
person
Provider Business Mailing Address Details
Address
1900 Lake Tahoe Blvd
City
South Lake Tahoe
State
California
Zip
96150-6305
Phone Number
530-573-7970
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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