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Organization
KAISER PERMANENTE
Active
Organization
KAISER PERMANENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TINA K DIETZ PHD (PSYCHOLOGIST)
(415) 833-4092
Entity
Organization
Contact information
Practice address
4141 GEARY BLVD FL 3, SAN FRANCISCO, CA 94118-3111
(415) 833-4092
Mailing address
4141 GEARY BLVD FL 3, SAN FRANCISCO, CA 94118-3111
(415) 833-4092
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 23391
CA
Other
Enumeration date
06/25/2010
Last updated
06/25/2010
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