Individual
DIANISHA DENISE KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5751 ADELINE ST, OAKLAND, CA 94608-2815
(510) 236-0044
Mailing address
4892 SAN PABLO DAM RD, EL SOBRANTE, CA 94803-3222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
106076
CA
Other
Enumeration date
11/02/2018
Last updated
06/18/2024
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