Provider Demographics
NPI:1821804956
Name:GARCIA, DIANNE JANE LANSANGAN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DIANNE JANE
Middle Name:LANSANGAN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:DIANNE JANE
Other - Middle Name:NACIS
Other - Last Name:LANSANGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 W LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-4097
Mailing Address - Country:US
Mailing Address - Phone:215-203-3000
Mailing Address - Fax:
Practice Address - Street 1:2600 N AMERICAN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-3413
Practice Address - Country:US
Practice Address - Phone:215-739-2669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030709363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health