Healthcare Provider Details

I. General information

NPI: 1194920249
Provider Name (Legal Business Name): MS. DIANE LOEHNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E VALLEY PKWY
ESCONDIDO CA
92025-3048
US

IV. Provider business mailing address

13760 SYCAMORE TREE LN
POWAY CA
92064-4654
US

V. Phone/Fax

Practice location:
  • Phone: 760-739-3246
  • Fax:
Mailing address:
  • Phone: 858-748-2903
  • Fax: 858-748-2903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23805
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: