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General NPI Number Information
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NPI Number | 1841420502
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Entity Type | Individual
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Provider Name | DIANE JOYCE SUTTON M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/15/2009
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Last Update Date | 07/15/2009
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Provider Practice Location Address
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Address Line | 101 W AMERICAN CANYON RD # 508-396
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-1162
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Country | US
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Telephone | 707-319-1203
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Fax | 707-554-2555
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Provider Business Mailing Address
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Address Line | 101 W AMERICAN CANYON RD # 508-396
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City | AMERICAN CANYON
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State | CA
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Zip | 94503-1162
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Country | US
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Telephone | 707-319-1203
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Fax | 707-554-2555
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C33897
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License Number State | CA
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