MEDICARE: MRS. DIANA REDEEMER MA., LPCC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPCC13013	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	382143740	OTHER	MI	TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073692133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIANA REDEEMER MA., LPCC, LPC

Provider Business Mailing Address
First Line	:	401 S TUSTIN ST BLDG D
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92866-2550
Country	:	US
Telephone Number	:	951-955-7320
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 S TUSTIN ST
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92866-2550
Country	:	US
Telephone Number	:	714-289-3936
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	09/23/2025

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