Provider Demographics
NPI:1821793795
Name:MOCHE, DIANE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:MOCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 LAVERNE DR
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1732
Mailing Address - Country:US
Mailing Address - Phone:240-595-9768
Mailing Address - Fax:
Practice Address - Street 1:1715 NEWTON ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2319
Practice Address - Country:US
Practice Address - Phone:202-526-1652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator