Provider Demographics
NPI:1134454101
Name:SARABIA, DIANA CALDERON (IMF 57398)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:CALDERON
Last Name:SARABIA
Suffix:
Gender:F
Credentials:IMF 57398
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4811 CHIPPENDALE DR
Mailing Address - Street 2:SUITE 601
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-2555
Mailing Address - Country:US
Mailing Address - Phone:916-267-5832
Mailing Address - Fax:
Practice Address - Street 1:4811 CHIPPENDALE DR
Practice Address - Street 2:SUITE 601
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-2555
Practice Address - Country:US
Practice Address - Phone:916-267-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF59693106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist