Provider Demographics
NPI:1902022189
Name:COLMAN, DIANE ROYCE (MFT, PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:ROYCE
Last Name:COLMAN
Suffix:
Gender:F
Credentials:MFT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50420 VIA AMANTE
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-7554
Mailing Address - Country:US
Mailing Address - Phone:760-340-4443
Mailing Address - Fax:760-771-2885
Practice Address - Street 1:44775 DEEP CANYON RD
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3724
Practice Address - Country:US
Practice Address - Phone:760-340-4443
Practice Address - Fax:760-771-2885
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 33692106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist