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General NPI Number Information
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NPI Number | 1801988431
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Entity Type | Individual
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Provider Name | RALPH G DINER PH.D, M.S.C.P.
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Gender | Male
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 16944 VENTURA BLVD STE 10
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City | ENCINO
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State | CA
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Zip | 91316-4161
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Country | US
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Telephone | 818-231-2164
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Fax |
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Provider Business Mailing Address
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Address Line | 20541 HIAWATHA ST
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City | CHATSWORTH
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State | CA
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Zip | 91311-2413
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Country | US
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Telephone | 818-231-2164
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PC7457
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License Number State | CA
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