Basic Information
| Provider Information | |||||||||
| NPI: | 1982042479 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANCO | ||||||||
| FirstName: | DIANA | ||||||||
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| Credential: | PSYCHOLOGY INTERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8171 PRESTWICK DR | ||||||||
| Address2: | |||||||||
| City: | LA JOLLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920372018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602593106 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3605 VISTA WAY STE 258 | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920564565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607581480 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2013 | ||||||||
| LastUpdateDate: | 11/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.