Healthcare Provider Details

I. General information

NPI: 1124301767
Provider Name (Legal Business Name): DIANE ADRIENNE O'SHEA MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15301 WARREN SHINGLE RD
BEALE AFB CA
95903-1905
US

IV. Provider business mailing address

15301 WARREN SHINGLE RD
BEALE AFB CA
95903-1905
US

V. Phone/Fax

Practice location:
  • Phone: 530-634-4133
  • Fax:
Mailing address:
  • Phone: 530-634-3423
  • Fax: 530-634-0607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number88692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: