Provider Demographics
NPI:1952130767
Name:DIAMOND, MIHAELA DORINA
Entity type:Individual
Prefix:
First Name:MIHAELA
Middle Name:DORINA
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4735 CALIFORNIA ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1524
Mailing Address - Country:US
Mailing Address - Phone:415-609-3980
Mailing Address - Fax:
Practice Address - Street 1:4735 CALIFORNIA ST APT 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1524
Practice Address - Country:US
Practice Address - Phone:415-609-3980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LCSW295591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical