Individual ProviderDiane M. SmithMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address16960 Bastanchury Rd, Suite J, Yorba Linda, CA 92886-1711(714) 449-2444(714) 997-5384PECOS EnrollmentBased on the most recent information from CMS, provider Diane M. Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:37 AM.Profile DetailsProvider ID1225110380Provider TypeIndividualFull NameSmith, Diane M.TitleMs.CredentialMFTGenderFemaleSole ProprietorYesEnumeration Date10/19/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address16960 Bastanchury Rd, Suite J, Yorba Linda, CA 92886-1711Phone(714) 449-2444FaxUnlisted FaxMailing LocationMailing AddressPO Box 1706, Orange, CA 92856-0706Phone(714) 997-5384FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC 33630CaliforniaProvider IdentifiersIDDescriptionIssuerIDMFC 33630DescriptionOtherIssuerMARRIAGE AND FAMILY LICENCalifornia