Provider Demographics
NPI:1720476138
Name:BARRANTES, DIANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:BARRANTES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:PATRICIA
Other - Last Name:BARRANTES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3298 GOVERNOR DR UNIT 22994
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92192-5039
Mailing Address - Country:US
Mailing Address - Phone:858-366-2730
Mailing Address - Fax:
Practice Address - Street 1:3298 GOVERNOR DR UNIT 22994
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92192-5039
Practice Address - Country:US
Practice Address - Phone:858-366-2730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical