Provider Demographics
NPI:1326412016
Name:SABESKY, DIANA LEA (PT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LEA
Last Name:SABESKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8599 SKY RIM DR
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-5513
Mailing Address - Country:US
Mailing Address - Phone:619-459-0657
Mailing Address - Fax:
Practice Address - Street 1:353 E PARK AVE
Practice Address - Street 2:#104
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3988
Practice Address - Country:US
Practice Address - Phone:619-334-4294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12573171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor