Provider Demographics
NPI:1518788330
Name:DIAMANTE, ANGELA MARY (LMFT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARY
Last Name:DIAMANTE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARY
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2025 LITTLE OAK WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-1425
Mailing Address - Country:US
Mailing Address - Phone:209-324-6372
Mailing Address - Fax:
Practice Address - Street 1:2025 LITTLE OAK WAY
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-1425
Practice Address - Country:US
Practice Address - Phone:209-324-6372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146407101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health