Provider Demographics
NPI:1639407604
Name:PALMER, DIANA MARIE (MS, ATC, EMT)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:PALMER
Suffix:
Gender:F
Credentials:MS, ATC, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 HIDDEN VALLEY LANE
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108
Mailing Address - Country:US
Mailing Address - Phone:805-455-3694
Mailing Address - Fax:
Practice Address - Street 1:3090 HIDDEN VALLEY LANE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108
Practice Address - Country:US
Practice Address - Phone:805-455-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer