MEDICARE: MS. DIANA T MACNEILL MFTI

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	101Y00000X	Counselor		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	347006067	OTHER	CA	DEPT OF SOCIAL SERVICES

General Provider Information

NPI Number	:	1881216851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANA T MACNEILL MFTI

Provider Business Mailing Address
First Line	:	8421 AUBURN BLVD # 162
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-0359
Country	:	US
Telephone Number	:	916-441-3819
Fax Number	:

Provider Business Practice Location Address
First Line	:	8421 AUBURN BLVD # 162
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-0359
Country	:	US
Telephone Number	:	916-441-6377
Fax Number	:

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

Provider Enumeration Date	:	05/13/2020
Last Update Date	:	06/09/2026

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