Provider Demographics
NPI:1437148319
Name:MASSER-FRYE, DIANE SUZANNE (MS, MSW)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:SUZANNE
Last Name:MASSER-FRYE
Suffix:
Gender:F
Credentials:MS, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6131 TAMILYNN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-3426
Mailing Address - Country:US
Mailing Address - Phone:858-638-9181
Mailing Address - Fax:858-966-8550
Practice Address - Street 1:3020 CHILDRENS WAY
Practice Address - Street 2:MC 5031
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:858-966-5840
Practice Address - Fax:858-966-8550
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS