| Doctor Name: | DIANA GAY PECK |
| NPI Number: | 1093953721 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ASW |
| License Number: | |
| Business Practice Address: | 891 Mountain Ranch Rd Health & Human Services Agency San Andreas, CA - 952499713 |
| Business Phone Number: | 2097546525 |
| Business Fax Number: | 2097549604 |
| Mailing Address: | 11310 Prospect Dr # 10-88, JACKSON |
| State: | CA |
| Postal Code: | 956429311 |
| Phone Number: | 2092176657 |
| Fax Number: | 2097549604 |
| NPI Enumeration Date: | 02/03/2009 |
| NPI Last Update Date: | 12/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |