MEDICARE: DR. DIANE DEUTSCH PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	PSY8517	CA

General Provider Information

NPI Number	:	1235350620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE DEUTSCH PH.D.

Provider Business Mailing Address
First Line	:	1719 UNION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-4406
Country	:	US
Telephone Number	:	415-648-9408
Fax Number	:

Provider Business Practice Location Address
First Line	:	1719 UNION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-4406
Country	:	US
Telephone Number	:	415-648-9408
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/20/2009

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