Provider Demographics
NPI:1649042797
Name:DIAZ-TORRES, MARTHA J (CHW)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:J
Last Name:DIAZ-TORRES
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4244 RIVERWALK PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3373
Mailing Address - Country:US
Mailing Address - Phone:951-781-6335
Mailing Address - Fax:951-781-6365
Practice Address - Street 1:4310 ORANGE ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3829
Practice Address - Country:US
Practice Address - Phone:951-781-6335
Practice Address - Fax:951-781-6365
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker