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KELLY ETHEL DIAZ
NPI 1104641059
Specialist/Technologist - Athletic Trainer in La Canada, CA

Active since November 16, 2024
200 FOOTHILL BLVD, LA CANADA, CA 91011(818) 826-1637 Get Directions Write a Review

NPPES record last updated: September 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 14, 2025, Nov 16, 2024 (2 updates tracked since 2024).

About Kelly Ethel Diaz NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ETHEL DIAZ (NPI 1104641059) is an individual athletic trainer provider in La Canada, California, licensed in California (2000058035) and active in the NPI registry since November 2024.

NPPES Registry Identity

NPI1104641059
Entity TypeIndividualFemale
Primary Taxonomy2255A2300X
Provider Legal NameKELLY ETHEL DIAZ
Location Address200 FOOTHILL BLVDLa Canada, CA 91011-3700
Mailing Address200 Foothill BlvdLa Canada, CA 91011-3700
Phone(818) 826-1637
Sole ProprietorNo
Enumeration DateNovember 16, 2024
Last NPPES UpdateSeptember 14, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 14, 2025
✔ NPI 1104641059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
Licenses✔ Licensed in CA · 2000058035✔ Licensed in NY · 004992
Definition
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
200 FOOTHILL BLVD, La Canada, CA 91011
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ELI WILLIAM HALLAK ATC
Specialist/Technologist (Athletic Trainer)
200 FOOTHILL BLVD
LA CANADA, CA 91011
Los Angeles County (818) 790-0325
JOEL DOERNING ATC
Specialist/Technologist (Athletic Trainer)
200 FOOTHILL BLVD
LA CANADA, CA 91011
Los Angeles County (818) 790-0325

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Diaz's NPI number?

The NPI number for Kelly Diaz is 1104641059. It was assigned to this individual provider in the NPPES registry on November 16, 2024.

Where is Kelly Diaz located?

Kelly Diaz practices at 200 Foothill Blvd, La Canada, CA 91011. The listed phone number is (818) 826-1637.

What is Kelly Diaz's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, specializing in Athletic Trainer, with taxonomy code 2255A2300X.

When was this NPI record last updated?

The NPPES record for Kelly Diaz was last updated on September 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.