Individual
HALEY DIEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, RN, CPNP-PC
Contact information
Practice address
6330 SAN VICENTE BLVD STE 500, LOS ANGELES, CA 90048-5455
(310) 854-0770
Mailing address
18734 HONEY TREE LN, NORTHVILLE, MI 48168-8605
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
95430562
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
95036514
CA
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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