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General NPI Number Information
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NPI Number | 1801289905
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Entity Type | Individual
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Provider Name | DIANNE L W GREENE M.A., MFT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2015
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 23480 PARK SORRENTO STE 209A
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City | CALABASAS
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State | CA
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Zip | 91302-1359
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Country | US
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Telephone | 818-569-3040
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Fax | 888-971-3942
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Provider Business Mailing Address
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Address Line | P.O. BOX 260692
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City | ENCINO
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State | CA
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Zip | 91426
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Country | US
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Telephone | 818-569-3040
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 80619...............
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License Number State | CA
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