Individual
DIANA PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3031 S VERMONT AVE, LOS ANGELES, CA 90007-3033
(323) 373-2400
Mailing address
3031 S VERMONT AVE, LOS ANGELES, CA 90007-3033
(323) 373-2400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
97577
CA
104100000X
Social Worker
Primary
118188
CA
1041C0700X
Clinical Social Worker
97577
CA
Other
Enumeration date
12/22/2020
Last updated
10/25/2023
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