Doctor Name: | MS. DIANE HUTT ANDERSON |
NPI Number: | 1003022534 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LCS 22996 |
Business Practice Address: | 2605 E. Foothill Boulevard #109 Glendora, CA - 91740 |
Business Phone Number: | 9099676236 |
Business Fax Number: | 9098619371 |
Mailing Address: | 2605 E Foothill Blvd, # 109 GLENDORA |
State: | CA |
Postal Code: | 917404003 |
Phone Number: | 9099676236 |
Fax Number: | 9098619371 |
NPI Enumeration Date: | 05/14/2007 |
NPI Last Update Date: | 08/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 07/25/2014 |
NPI Reactivation Date: | 08/04/2014 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS 22996 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |