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Individual

DIANA MORENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230-4820
(310) 751-5438
Mailing address
1328 W MANCHESTER AVE, LOS ANGELES, CA 90044-2240
(323) 778-9593

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ASW111511
CA
104100000X
Social Worker
Primary
ASW111511
CA
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
08/19/2021
Last updated
06/23/2023
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