Healthcare Provider Details

I. General information

NPI: 1235668310
Provider Name (Legal Business Name): DIANA DINESCU PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 BEVERLY RD STE 320
MC LEAN VA
22101-3648
US

IV. Provider business mailing address

324 ELLEN DR
FRONT ROYAL VA
22630-9207
US

V. Phone/Fax

Practice location:
  • Phone: 703-556-6655
  • Fax:
Mailing address:
  • Phone: 617-756-6702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810006124
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: