Provider Information for 1114939311
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Ms. DOREEN ANN DIEGO MA, MFT Intern
Sex: Female
NPI: 1114939311
Last Updated: 2019-06-06
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114939311 | ||||||||||||
| Enumeration Date | 2006-08-13 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3331 POWER INN RD STE 180 SACRAMENTO, CA 95826-3889 United States Phone: 916-876-5434 | Fax: | ||||||||||||
| Primary Practice Address | 3331 POWER INN RD STE 180 SACRAMENTO, CA 95826-3889 United States Phone: 916-876-5434 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 2330 GLENDALE LN # 100 | ||||||||||||
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