Provider Demographics
NPI:1447276647
Name:AUBURN, DIANE C (PHD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:C
Last Name:AUBURN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2580 E MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2646
Mailing Address - Country:US
Mailing Address - Phone:805-647-4591
Mailing Address - Fax:805-647-4591
Practice Address - Street 1:2580 E MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2646
Practice Address - Country:US
Practice Address - Phone:805-647-4591
Practice Address - Fax:805-647-4591
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11670103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0323924Medicaid
CA0323924Medicaid
CAR15654Medicare UPIN