Provider Demographics
NPI:1669551289
Name:WHITMAN, DENISE DIANE (CADC)
Entity type:Individual
Prefix:MR
First Name:DENISE
Middle Name:DIANE
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31218 COMOTILO CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5707
Mailing Address - Country:US
Mailing Address - Phone:760-807-7625
Mailing Address - Fax:
Practice Address - Street 1:130 S FIG ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4401
Practice Address - Country:US
Practice Address - Phone:760-741-5098
Practice Address - Fax:760-432-4297
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA8513105101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)