DIANE PARK MD LLC NPI 1972847903

NPI Information

  • NPI: 1972847903
  • Provider Name: DIANE PARK MD LLC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Address: 1845 S DOBSON RD
    SUITE 109
    MESA, AZ
    ZIP 85202
  • Phone: (480) 204-2477

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NPI Details

DIANE PARK MD LLC is a mental health counselor in Mesa, AZ. DIANE PARK MD LLC NPI is 1972847903. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1845 S DOBSON RD
SUITE 109
MESA, AZ
ZIP 85202-661
Phone: (480) 204-2477

The provider's authorized official is Diane Park .
The authorized official title is Owner and has the following contact phone number (480) 204-2477.

The enumeration date for this NPI number is 11/15/2012 and was last updated on 11/15/2012.

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
1101YM0800XCounselorMental Health32107ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11609946672OTHERARIZONAINDIVIDUAL NPI NUMBER

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: 11/21/2025

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