Provider Demographics
NPI:1609611037
Name:DIOGO, DANAE VIEIRA
Entity type:Individual
Prefix:MISS
First Name:DANAE
Middle Name:VIEIRA
Last Name:DIOGO
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 1:27254 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94542-2325
Mailing Address - Country:US
Mailing Address - Phone:510-688-8166
Mailing Address - Fax:
Practice Address - Street 1:3045 GROVE WAY
Practice Address - Street 2:CASTRO VALLEY, CA 94546
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546
Practice Address - Country:US
Practice Address - Phone:510-688-8166
Practice Address - Fax:510-397-2939
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician