Provider Demographics
NPI:1942295688
Name:DIEHL, DOROTHY DEBORAH (MFT)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:DEBORAH
Last Name:DIEHL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4246 VENICE LN
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-1212
Mailing Address - Country:US
Mailing Address - Phone:805-684-6022
Mailing Address - Fax:805-684-6022
Practice Address - Street 1:4482 MARKET ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7780
Practice Address - Country:US
Practice Address - Phone:805-644-3778
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21023106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist