Individual
DR. DIANNE ILENE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
3000 Q ST, 4TH FLOOR PODIATRY, SACRAMENTO, CA 95816-7058
(916) 733-3359
(916) 733-3462
Mailing address
3000 Q ST, 4TH FLOOR PODIATRY, SACRAMENTO, CA 95816-7058
(916) 733-3359
(916) 733-3462
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E-4683
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
PO00000826
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4283MI
BLUE SHIELD # VM
WA
05
—
8493975
—
WA
01
—
US9237053
AETNA PCP PIN VM
WA
Enumeration date
06/06/2007
Last updated
09/26/2012
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