Provider Demographics
NPI:1750433876
Name:MIZE, DIANE TURINI (MFT)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:TURINI
Last Name:MIZE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4309 DEEPWELL LN
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-2304
Mailing Address - Country:US
Mailing Address - Phone:805-529-9343
Mailing Address - Fax:
Practice Address - Street 1:1633 ERRINGER RD
Practice Address - Street 2:SUITE 207
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3557
Practice Address - Country:US
Practice Address - Phone:805-578-2425
Practice Address - Fax:805-578-8769
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38366106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1750433876OtherANTHEM BLUE CROSS