Healthcare Provider Details

I. General information

NPI: 1881216851
Provider Name (Legal Business Name): DIANA T MACNEILL MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 09/08/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8421 AUBURN BLVD # 162
CITRUS HEIGHTS CA
95610-0359
US

IV. Provider business mailing address

8421 AUBURN BLVD # 162
CITRUS HEIGHTS CA
95610-0359
US

V. Phone/Fax

Practice location:
  • Phone: 916-441-6377
  • Fax:
Mailing address:
  • Phone: 916-441-3819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT165143
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: