Provider Demographics
NPI:1447976824
Name:DIAZ, VICTORIA (WELLNESS NP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:WELLNESS NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5909 NORTHWEST EXPRESSWAY
Mailing Address - Street 2:#219
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132
Mailing Address - Country:US
Mailing Address - Phone:914-363-8480
Mailing Address - Fax:
Practice Address - Street 1:5909 NORTHWEST EXPRESSWAY
Practice Address - Street 2:#219
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132
Practice Address - Country:US
Practice Address - Phone:914-363-8480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach