Provider Demographics
NPI:1245765098
Name:LOZOYA, DIANA ROSE (LMFT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:ROSE
Last Name:LOZOYA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5198 ARLINGTON AVE # 700
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-2603
Mailing Address - Country:US
Mailing Address - Phone:619-693-8289
Mailing Address - Fax:
Practice Address - Street 1:2835 CAMINO DEL RIO S STE 120
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3825
Practice Address - Country:US
Practice Address - Phone:619-908-9908
Practice Address - Fax:619-297-4496
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X, 101YM0800X
CA122981106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health