Look up the most recent NPI and PECOS records

Diana Mandujano

Marriage & Family Therapist

Behavioral Health & Social Service Providers

5275 Claremont Ave, Oakland, CA 94618-1032

PECOS Enrollment

Based on the most recent information from CMS, provider Diana Mandujano is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 33 days ago.

Profile Details

Provider ID
1154870525
Provider Type
Individual
Full Name
Mandujano, Diana
Credential
LMFT

Gender
Female
Sole Proprietor
No
Enumeration Date
9/27/2016
Last Updated
12/14/2020

Contact Information

Practice Location

5275 Claremont Ave, Oakland, CA 94618-1032

(510) 428-3000

Unlisted Fax

Mailing Location

5275 Claremont Ave, Oakland, CA 94618-1032

(510) 428-3000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Diana Mandujano

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Gunther-Murphy, Marianne

Ehat, Rosemary

Tsuchiya, Kyoko

Lezin, Alexis

Gleghorn, Diana

Stansfield, Millie

Swedlow, Kara

Lankamp, Barbara

Zhang, Ni

Shragai, David