Provider Demographics
NPI:1336374206
Name:GALVAN ELGAMMAL, DIANA MARIE (B,A)
Entity type:Individual
Prefix:MISS
First Name:DIANA
Middle Name:MARIE
Last Name:GALVAN ELGAMMAL
Suffix:
Gender:F
Credentials:B,A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 IVORY LN
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-7430
Mailing Address - Country:US
Mailing Address - Phone:209-535-1122
Mailing Address - Fax:209-667-9057
Practice Address - Street 1:642 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340
Practice Address - Country:US
Practice Address - Phone:209-205-1061
Practice Address - Fax:209-205-1062
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor