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General NPI Number Information
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NPI Number | 1326955071
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Entity Type | Organization
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Legal Business Name | DIAMOND COLLECTIVE
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 4044 ANDEDON CIR
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City | SACRAMENTO
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State | CA
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Zip | 95826-5506
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Country | US
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Telephone | 916-793-1213
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Fax |
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Provider Business Mailing Address
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Address Line | 4044 ANDEDON CIR
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City | SACRAMENTO
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State | CA
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Zip | 95826-5506
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Country | US
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Telephone | 916-793-1213
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Fax |
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Authorized Official
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Title or Position | FOUNDER, CEO
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Name | ASHLEY DANIELLE FAISON-MADDOX
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Credential |
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Telephone | 916-793-1213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NULL
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