Individual
DIANE MASCARENAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11741 TELEGRAPH RD, SANTA FE SPRINGS, CA 90670-3681
(562) 942-8256
(562) 949-3587
Mailing address
11741 TELEGRAPH RD, SANTA FE SPRINGS, CA 90670-3681
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
32200
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167G00000X
—
CA
Enumeration date
10/17/2017
Last updated
10/17/2017
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