DIANE PARK MD LLC (NPI# 1972847903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972847903 |
| Entity Type | Organization |
| Organization Name | DIANE PARK MD LLC |
| Practice Address |
1845 S Dobson Rd Suite 109 Mesa AZ 85202-5661 |
| Practice Telephone | 4802042477 |
| Mailing Telephone | 4802042477 |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |
| Authorized Official Name | DIANE PARK (OWNER) |
| Authorized Official Telephone | 4802042477 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
32107 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | INDIVIDUAL NPI NUMBER | 1609946672 | 01 |
| Street Address |
1845 S DOBSON RD SUITE 109 |
| City | MESA |
| State | AZ |
| Zip Code | 85202-5661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801850185 | Colleen R Kumia | Social Worker | 1845 S Dobson Rd, Suite 207, Mesa, AZ 85202-5661 | 2006-04-14 |
| 1558895417 | Deanne Wilson | Dietitian, Registered | 1845 S Dobson Rd, Suite 213, Mesa, AZ 85202-5661 | 2017-04-18 |
| 1144769795 | Palmetto Counseling and Wellness, Pllc | Community/Behavioral Health | 1845 S Dobson Rd, Suite 207, Mesa, AZ 85202-5661 | 2017-02-15 |
| 1386183135 | Jacquelyn Nelson | Counselor | 1845 S Dobson Rd, Suite 207, Mesa, AZ 85202-5661 | 2017-02-13 |
| 1215488028 | Travis Mowery | Naturopath | 1845 S Dobson Rd, Suite 111, Mesa, AZ 85202-5661 | 2016-10-17 |
| 1528422912 | Young Ju Lee | Naturopath | 1845 S Dobson Rd, Suite 111, Mesa, AZ 85202-5661 | 2016-04-12 |
| 1457720799 | Ronelle Holloway | Naturopath | 1845 S Dobson Rd, Suite 111, Mesa, AZ 85202-5661 | 2015-09-16 |
| 1316315526 | Wilfred Meeds | Naturopath | 1845 S Dobson Rd, Mesa, AZ 85202-5661 | 2015-09-03 |
| 1538543244 | Hay Counseling and Consulting, Inc. | Counselor | 1845 S Dobson Rd, Suite 207, Mesa, AZ 85202-5661 | 2015-07-13 |
| 1407252422 | Crystal Abbott | Naturopath | 1845 S Dobson Rd, Mesa, AZ 85202-5661 | 2014-11-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275173536 | Samuel A Wolde | Counselor | Clear View Counseling, 2651 W Guadalupe Rd, Mesa, AZ 85202 | 2020-01-14 |
| 1912549171 | Lauren Barbara Loges | Occupational Therapist | 2225 E. Southern Avenue, Mesa, AZ 85202 | 2019-10-09 |
| 1245724822 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1450 S Dobson Rd Ste B326, Mesa, AZ 85202 | 2018-06-18 |
| 1457843310 | Jay Douglas Baumgardner | Physical Therapist | 1941 W. Guadalupe Rd. Suite 109, Mesa, AZ 85202 | 2018-06-05 |
| 1144746215 | Alyson Fix | Physician Assistant | 1432 S Dobson Rd Ste 304, Mesa, AZ 85202 | 2017-08-20 |
| 1194108852 | Robert Dale Labrum | Counselor | 1255 W Baseline Rd Ste B-258, Mesa, AZ 85202 | 2015-06-30 |
| 1114325677 | John David Shull Jr. | Physician Assistant | 1520 S Dobson Rd Ste 305, Mesa, AZ 85202 | 2014-12-16 |
| 1316356207 | Embry Womens Health LLC | Nurse Practitioner | 2204 S Dobson Road, Suite 203, Mesa, AZ 85202 | 2014-08-05 |
| 1619312899 | Fiza Naueed Khan | Internal Medicine | 1400 South Dobson Road, Attn: Bmg Hospitalists Team/amanda Gump, Mesa, AZ 85202 | 2013-05-01 |
| 1487903373 | Jodi Lynn Mealer | Pharmacist | 1951 W. Baseline Rd., Mesa, AZ 85202 | 2012-09-06 |
| Find all providers in zip 85202 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496054 | Ryse Therapeutic Counseling LLC | Counselor | 461 W Holmes Ave Unit 181, Mesa, AZ 85210-5181 | 2020-10-27 |
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1467060350 | Torch Wellness and Consulting LLC | Counselor | 3707 E Southern Ave Ste 1029, Mesa, AZ 85206-6202 | 2020-07-16 |
| 1750904736 | Colin Bennett | Counselor | 1234 S Power Rd Ste 100, Mesa, AZ 85206-3740 | 2020-05-25 |
| 1386267508 | Devyn H Davis | Counselor | 30 E Brown Rd Unit 1054, Mesa, AZ 85201-3527 | 2020-05-21 |
| 1376165266 | Therapy LLC | Counselor | 1818 E Southern Ave Ste 3a, Mesa, AZ 85204-5247 | 2020-05-13 |
| 1902432107 | Connie Rae Parker | Counselor | 1955 S Val Vista Dr, Mesa, AZ 85204-7370 | 2020-03-19 |
| 1265065544 | Phillip Micheal Garrison | Counselor | 1741 S Clearview Ave Unit 7, Mesa, AZ 85209-4005 | 2020-02-14 |
| 1275173536 | Samuel A Wolde | Counselor | Clear View Counseling, 2651 W Guadalupe Rd, Mesa, AZ 85202 | 2020-01-14 |
| 1053951913 | Candace Delight Cook | Counselor | 3707 E Southern Ave Ste 2016, Mesa, AZ 85206-6213 | 2020-01-08 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.