Provider Demographics
NPI:1700518362
Name:TUTTLE, DIANA LYNN (LMFT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 NEWPORT BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2278
Mailing Address - Country:US
Mailing Address - Phone:949-385-1449
Mailing Address - Fax:
Practice Address - Street 1:1901 NEWPORT BLVD STE 350
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-2278
Practice Address - Country:US
Practice Address - Phone:949-478-0163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT132302101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health