Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MFC#32990 | CA |
NPI | 1003090044 |
---|---|
Provider Name | Ms. Diane Mary Oakes |
First Address | Vista, CA 92084 |
Second Address | Vista, CA 92084-5251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2007 |
Last Update Date | 27/12/2007 |