Individual
ANTHONY DIETEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18646 OXNARD ST, TARZANA, CA 91356-1411
(818) 996-1051
Mailing address
18014 SHERMAN WAY APT 123, RESEDA, CA 91335-4649
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
175T00000X
Peer Specialist
—
—
Other
Enumeration date
10/23/2023
Last updated
01/17/2025
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