Provider Demographics
NPI:1700948379
Name:MEYER-SASADA, DIANNE MARIE (MS,MFT)
Entity Type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:MARIE
Last Name:MEYER-SASADA
Suffix:
Gender:F
Credentials:MS,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 E HIGH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-1151
Mailing Address - Country:US
Mailing Address - Phone:805-341-3234
Mailing Address - Fax:805-529-5272
Practice Address - Street 1:165 E HIGH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1151
Practice Address - Country:US
Practice Address - Phone:805-341-3234
Practice Address - Fax:805-529-5272
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health