Provider Demographics
NPI:1437399755
Name:PRENTISS, DIANE E (MA, MPH)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:E
Last Name:PRENTISS
Suffix:
Gender:F
Credentials:MA, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 HOWARD ST FL 5
Mailing Address - Street 2:COMMUNITY BEHAVIORAL HEALTH SERVICES (CBHS)
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2652
Mailing Address - Country:US
Mailing Address - Phone:415-255-3419
Mailing Address - Fax:
Practice Address - Street 1:1380 HOWARD ST FL 5
Practice Address - Street 2:COMMUNITY BEHAVIORAL HEALTH SERVICES (CBHS)
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2652
Practice Address - Country:US
Practice Address - Phone:415-255-3419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst