Provider Demographics
NPI:1962267484
Name:SWIRSKY, DIANE (PHD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:SWIRSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 WARD ST STE 204
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1147
Mailing Address - Country:US
Mailing Address - Phone:510-444-5458
Mailing Address - Fax:510-444-5458
Practice Address - Street 1:2340 WARD ST STE 204
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1147
Practice Address - Country:US
Practice Address - Phone:510-444-5458
Practice Address - Fax:510-444-5458
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13306103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist