Provider Demographics
NPI:1598324196
Name:FERRARI, DIANA MARIE (MA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:FERRARI
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 1:3463 STATE ST # 459
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-2662
Mailing Address - Country:US
Mailing Address - Phone:805-965-6830
Mailing Address - Fax:
Practice Address - Street 1:3 W CARRILLO ST STE 209
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3205
Practice Address - Country:US
Practice Address - Phone:805-965-6830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23921106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist