Individual
DR. DIANE ESCOFFON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1001 BROADWAY, JACKSON, CA 95642-2649
(209) 256-1998
Mailing address
PO BOX 106, JACKSON, CA 95642-0106
(650) 483-8991
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY18636
CA
Other
Enumeration date
10/11/2011
Last updated
01/09/2012
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