Provider Demographics
NPI:1245447002
Name:SKARSTEN, MARY BETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:BETH
Last Name:SKARSTEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:BETH
Other - Last Name:DINERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:101 GREGORY LANE
Mailing Address - Street 2:SUITE #33
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523
Mailing Address - Country:US
Mailing Address - Phone:925-827-9876
Mailing Address - Fax:925-827-1008
Practice Address - Street 1:101 GREGORY LANE
Practice Address - Street 2:SUITE #33
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523
Practice Address - Country:US
Practice Address - Phone:925-827-9876
Practice Address - Fax:925-827-1008
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2006185103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical