Individual
DIANE D WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
41690 ENTERPRISE CIR N STE 200A, TEMECULA, CA 92590-5618
(951) 973-9624
(951) 246-7107
Mailing address
PO BOX 5, SUN CITY, CA 92586-0005
(951) 973-9624
(951) 246-7107
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 21687
CA
Other
Enumeration date
04/10/2008
Last updated
08/05/2009
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