Provider Demographics
NPI:1841420502
Name:SUTTON, DIANE JOYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:JOYCE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W AMERICAN CANYON RD # 508-396
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-1162
Mailing Address - Country:US
Mailing Address - Phone:707-319-1203
Mailing Address - Fax:707-554-2555
Practice Address - Street 1:101 W AMERICAN CANYON RD # 508-396
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-1162
Practice Address - Country:US
Practice Address - Phone:707-319-1203
Practice Address - Fax:707-554-2555
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC338972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry