Provider Demographics
NPI:1184446692
Name:GILBERT, DIANA (EDD, LEP, NCSP)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:EDD, LEP, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 83
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95381-0083
Mailing Address - Country:US
Mailing Address - Phone:209-410-9329
Mailing Address - Fax:
Practice Address - Street 1:222 S THOR ST STE 14
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4977
Practice Address - Country:US
Practice Address - Phone:209-410-9329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-26
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4281103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist