THEODORE KURT DIETZ ACSW NPI 1205589652

NPI Information

NPI: 1205589652
Provider Name: THEODORE KURT DIETZ, ACSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
204 HAMPTON DR
VENICE, CA
ZIP 90291
Phone: (310) 279-3499
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Theodore Kurt Dietz, ACSW is a mental health counselor in Venice, CA. Theodore Kurt Dietz, ACSW NPI is 1205589652. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

204 HAMPTON DR
VENICE, CA
ZIP 90291-633
Phone: (310) 279-3499

The enumeration date for this NPI number is 1/26/2022 and was last updated on 2/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	106405	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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