Diane Mitzenmacher, LCSW Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

DIANE MITZENMACHER, LCSW INC

Practice address

8300 Utica Ave Ste 155
Rancho Cucamonga, CA 91730-7605

Phone

(909) 285-5205

Fax

(909) 989-4648

NPI assigned

Apr 19, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane Mitzenmacher, LCSWNPI 1649366394

Title

President

Phone

(909) 285-5205

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diane Mitzenmacher, LCSW

  • Clinical Social Worker
  • Rancho Cucuamonga, CA
  • NPI 1649366394
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555632000000",
    "number": "1497318943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 938",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917290938",
            "telephone_number": "909-285-5205",
            "fax_number": "909-989-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 UTICA AVE STE 155",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307605",
            "telephone_number": "909-285-5205",
            "fax_number": "909-989-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANE MITZENMACHER, LCSW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-19",
        "last_updated": "2019-04-19",
        "status": "A",
        "authorized_official_last_name": "MITZENMACHER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-285-5205",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Wanland Dey, PSYD
• Krishma K Dhillon, PHARM.D.
• Parker Diamond, PT, DPT
• Flora Eloho Diamreyan, FNP
• Diane Bellwood, Inc
• Holly Dias
• Arlina Marie Diaz
• Ashley Diaz, MSW
• Corrina Diaz, M.ED., BCBA
• Diana Diaz, MS

• Mental Health Clinic/Center (Including Community Mental Health Center) in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.