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NPI Code Detail

MEDICARE: MS. MICHELLE DIEP AMFT

MEDICARE: MS. MICHELLE DIEP AMFT
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1629731963
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE DIEP AMFT
Provider Business Mailing Address
First Line : PO BOX 4121
Second Line :
City : COSTA MESA
State : CA
Zip : 92628-4121
Country : US
Telephone Number : 714-482-3119
Fax Number :
Provider Business Practice Location Address
First Line : 300 S HARBOR BLVD STE 910
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-3721
Country : US
Telephone Number : 562-821-1491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2021
Last Update Date : 05/22/2025

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