Provider Demographics
NPI:1437288990
Name:LE BLANC, DIANA MARI (MA)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:MARI
Last Name:LE BLANC
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 E LASSEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0811
Mailing Address - Country:US
Mailing Address - Phone:530-342-4250
Mailing Address - Fax:
Practice Address - Street 1:10 INDEPENDENCE CIR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0381
Practice Address - Country:US
Practice Address - Phone:530-345-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist