Provider Demographics
NPI:1285899120
Name:TERRONES, DIANE A
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:A
Last Name:TERRONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E GILBERT ST
Mailing Address - Street 2:COTTAGE #4
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-0911
Mailing Address - Country:US
Mailing Address - Phone:909-387-7003
Mailing Address - Fax:909-387-7611
Practice Address - Street 1:900 E GILBERT ST
Practice Address - Street 2:COTTAGE #4
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-0911
Practice Address - Country:US
Practice Address - Phone:909-387-7003
Practice Address - Fax:909-387-7611
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker