Provider Demographics
NPI:1528714797
Name:ZAKHOUR, DIANA
Entity type:Individual
Prefix:MISS
First Name:DIANA
Middle Name:
Last Name:ZAKHOUR
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 1:5901 ENCINA RD STE A
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2270
Mailing Address - Country:US
Mailing Address - Phone:805-681-0035
Mailing Address - Fax:
Practice Address - Street 1:5901 ENCINA RD STE A
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-2270
Practice Address - Country:US
Practice Address - Phone:805-681-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD10577251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical