Provider Demographics
NPI:1720004500
Name:WHEELER-CALLIN, DIANNE P (PHD)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:P
Last Name:WHEELER-CALLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3292 E FLORIDA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-4941
Mailing Address - Country:US
Mailing Address - Phone:951-766-4690
Mailing Address - Fax:951-766-4691
Practice Address - Street 1:3292 E FLORIDA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-4941
Practice Address - Country:US
Practice Address - Phone:951-766-4690
Practice Address - Fax:951-766-4691
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9169103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical