MEDICARE: DIANE LOUISE CHASE

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	175T00000X	Peer Specialist	MPSS-Q4W40I	CA
2	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1407788292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE LOUISE CHASE

Provider Business Mailing Address
First Line	:	1340 ARNOLD DR STE 200
Second Line	:
City	:	MARTINEZ
State	:	CA
Zip	:	94553-4189
Country	:	US
Telephone Number	:	925-393-2052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 ARNOLD DR STE 200
Second Line	:
City	:	MARTINEZ
State	:	CA
Zip	:	94553-4189
Country	:	US
Telephone Number	:	925-393-2052
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/09/2026

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Directions to “ DIANE LOUISE CHASE ” Practice Location

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