Healthcare Provider Details

I. General information

NPI: 1952258741
Provider Name (Legal Business Name): KHOI DIEP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 LA MESA BLVD STE 7
LA MESA CA
91942-6208
US

IV. Provider business mailing address

10424 WESTWARD CT
SAN DIEGO CA
92131-6153
US

V. Phone/Fax

Practice location:
  • Phone: 619-535-8709
  • Fax:
Mailing address:
  • Phone: 619-535-8709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: