Individual
DIANNE ELISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY 12309
Contact information
Practice address
5349 COLLEGE AVE, OAKLAND, CA 94618-1416
(510) 653-5575
Mailing address
5349 COLLEGE AVE, OAKLAND, CA 94618-1416
(510) 653-5575
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY12309
CA
Other
Enumeration date
01/24/2026
Last updated
01/24/2026
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