Provider Demographics
NPI:1972771640
Name:FOSTER, DIANE LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:LYNN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1180
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-0928
Mailing Address - Country:US
Mailing Address - Phone:707-761-7083
Mailing Address - Fax:
Practice Address - Street 1:1111 E TAHQUITZ CANYON WAY STE 121
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-0102
Practice Address - Country:US
Practice Address - Phone:707-761-7083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA244301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical