Provider Demographics
NPI:1770518094
Name:CONTINO, DIANNA LYNN (MA-CCC)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:LYNN
Last Name:CONTINO
Suffix:
Gender:F
Credentials:MA-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24241 CHRISANTA DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-4003
Mailing Address - Country:US
Mailing Address - Phone:949-215-5618
Mailing Address - Fax:
Practice Address - Street 1:1929 MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6524
Practice Address - Country:US
Practice Address - Phone:949-797-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12549235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist