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Organization
DRK CO
Active
Organization
DRK CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANA RUTH KRISHUN LCSW523CBD9511 (PRESIDENT)
(310) 530-9475
Entity
Organization
Contact information
Practice address
22930 CRENSHAW BLVD., STE A-2, TORRANCE, CA 90505
(323) 345-4969
(310) 530-9475
Mailing address
1785 SAHARA AVE, STE 490-983, LOS VEGAS, NV 89104
(800) 829-4933
(310) 530-9475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5239511
CA
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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