| Doctor Name: | DIANA SANBORN |
| NPI Number: | 1467425025 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY 15069 |
| Business Practice Address: | 1030 Sf Drake Blvd Suite 100-2 Kentfield, CA - 949041411 |
| Business Phone Number: | 4157212884 |
| Business Fax Number: | 4154826642 |
| Mailing Address: | 1030 S. F. Drake Blvd., Suite 100-2 KENTFIELD |
| State: | CA |
| Postal Code: | 949041438 |
| Phone Number: | 4157212884 |
| Fax Number: | 4154826642 |
| NPI Enumeration Date: | 02/13/2006 |
| NPI Last Update Date: | 07/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 15069 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |