Individual
DIANE TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12912 BROOKHURST ST STE 480, GARDEN GROVE, CA 92840-4867
(714) 636-6286
Mailing address
12912 BROOKHURST ST STE 480, GARDEN GROVE, CA 92840-4867
(714) 636-6286
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
CA
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/11/2021
Last updated
03/31/2025
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