Provider Demographics
NPI:1255166013
Name:HERRERA, DIANNE MARIE
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:MARIE
Last Name:HERRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2852
Mailing Address - Country:US
Mailing Address - Phone:619-915-1227
Mailing Address - Fax:
Practice Address - Street 1:1294 N MOLLISON AVE APT 104
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-4720
Practice Address - Country:US
Practice Address - Phone:619-915-1227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)