MEDICARE: DIANA KAY HERRINGTON

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	106H00000X	Marriage & Family Therapist	MFC27850	CA

General Provider Information

NPI Number	:	1730756826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA KAY HERRINGTON

Provider Business Mailing Address
First Line	:	41865 BOARDWALK STE 121
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-9032
Country	:	US
Telephone Number	:	760-340-9590
Fax Number	:	760-862-9273

Provider Business Practice Location Address
First Line	:	41865 BOARDWALK STE 121
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-9032
Country	:	US
Telephone Number	:	760-340-9590
Fax Number	:	760-862-9273

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

Provider Enumeration Date	:	06/07/2021
Last Update Date	:	06/07/2021

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