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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 LCSW CBD (PRESIDENT)
(310) 530-9475
Entity
Organization
Contact information
Practice address
22930 CRENSHAW BLVD, SUITE A-2, TORRANCE, CA 90505
(323) 345-4969
(310) 530-9475
Mailing address
26015 NARBONNE AVE, SUITE 15, LOMITA, CA 90717-3026
(323) 345-4969
(310) 530-9475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS523CBD9511
CA
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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