Provider Demographics
NPI:1326479049
Name:MANI, DIANNE EY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DIANNE
Middle Name:EY
Last Name:MANI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:DIANNE
Other - Middle Name:LORRAINE
Other - Last Name:EY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:601 VALERI RUTH CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5590
Mailing Address - Country:US
Mailing Address - Phone:530-902-2337
Mailing Address - Fax:
Practice Address - Street 1:601 VALERI RUTH CT
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-5590
Practice Address - Country:US
Practice Address - Phone:530-902-2337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24841103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist