MEDICARE: DIANA KOPADO

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1578428884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA KOPADO

Provider Business Mailing Address
First Line	:	3230 SWEETWATER SPRINGS BLVD
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-6934
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3230 SWEETWATER SPRINGS BLVD
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-6934
Country	:	US
Telephone Number	:	619-660-3000
Fax Number	:

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

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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Directions to “ DIANA KOPADO ” Practice Location

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