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General NPI Number Information
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NPI Number | 1831708544
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Entity Type | Individual
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Provider Name | JENNIFER SARA DIAMOND LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 5297 COLLEGE AVE STE 102
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City | OAKLAND
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State | CA
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Zip | 94618-1462
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Country | US
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Telephone | 510-361-0346
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Fax |
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Provider Business Mailing Address
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Address Line | 395 VAN BUREN AVE APT 101
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City | OAKLAND
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State | CA
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Zip | 94610-4881
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Country | US
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Telephone | 510-847-1908
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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 | 119961
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License Number State | CA
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