Healthcare Provider Details

I. General information

NPI: 1073692133
Provider Name (Legal Business Name): DIANA REDEEMER MA., LPCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S TUSTIN ST
ORANGE CA
92866-2550
US

IV. Provider business mailing address

401 S TUSTIN ST BLDG D
ORANGE CA
92866-2550
US

V. Phone/Fax

Practice location:
  • Phone: 714-289-3936
  • Fax:
Mailing address:
  • Phone: 951-955-7320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC13013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: