Provider Demographics
NPI:1801936885
Name:SHUMAY, DIANNE M (PHD)
Entity type:Individual
Prefix:DR
First Name:DIANNE
Middle Name:M
Last Name:SHUMAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:440 N BARRANCA AVE # 1801
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1722
Mailing Address - Country:US
Mailing Address - Phone:800-924-7811
Mailing Address - Fax:877-349-1868
Practice Address - Street 1:7008 SALEM AVE # 117
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2226
Practice Address - Country:US
Practice Address - Phone:800-924-7811
Practice Address - Fax:877-349-1868
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40125103TH0100X
OHP.08596103TH0100X
MI6301019445103TH0100X
CA21198103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0042921Medicaid