Provider Demographics
NPI:1447325394
Name:DIAZ, STEPHANIE LYNN NEWHART (MS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNN NEWHART
Last Name:DIAZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:275 W MACARTHUR BLVD
Mailing Address - Street 2:GENETICS DEPT
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5641
Mailing Address - Country:US
Mailing Address - Phone:510-752-6302
Mailing Address - Fax:510-752-6754
Practice Address - Street 1:3505 BROADWAY
Practice Address - Street 2:GENETICS DEPT - 10TH FLOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5714
Practice Address - Country:US
Practice Address - Phone:510-752-6302
Practice Address - Fax:510-752-6754
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS