Individual
DIANE MARIE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
19322 JESSE LN, RIVERSIDE, CA 92508-5072
(951) 387-4040
Mailing address
4164 BROCKTON AVE, RIVERSIDE, CA 92501-3400
(951) 683-5193
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCS 23656
CA
Other
Enumeration date
05/04/2007
Last updated
06/19/2023
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