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Individual

DR. JUDITH K DIETCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D

Contact information

Practice address
200 S MAIN ST, STE D, TEMPLETON, CA 93465-9366
(805) 434-3586
Mailing address
PO BOX 448, TEMPLETON, CA 93465-0448
(805) 434-3586

Taxonomy

Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSY7294
PSYCHOLOGIST LIC
CA
Enumeration date
04/13/2007
Last updated
10/06/2016
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