Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Ethel Diaz

Individual provider Athletic Trainer · NPI 1104641059

Kelly Ethel Diaz is an Athletic Trainer in LA Canada, California. Licensed in California and New York. Registered with an NPI since 2024.

Licensed in
CA, NY
In the registry since
2024
Specialties on file
2

Practice location Address checks out

200 Foothill Blvd
LA Canada, CA 91011-3700
Phone: (818) 826-1637
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2000058035 (CA)
Athletic Trainer Taxonomy 2255A2300X · Licence 004992 (NY)

Record details

NPI number1104641059
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 16, 2024
Last updated in NPPESSeptember 14, 2025
Certification dateSeptember 14, 2025

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