Individual
DR. DIANA M. CONCANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
23430 HAWTHORNE BLVD STE 210, TORRANCE, CA 90505-4732
(310) 625-8483
Mailing address
409 N PACIFIC COAST HWY, REDONDO BEACH, CA 90277-2870
(310) 625-8483
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
019686
NY
103T00000X
Psychologist
8109380-2501
UT
103T00000X
Psychologist
PSY10000763
DC
103T00000X
Psychologist
PSY1000763
DC
103T00000X
Psychologist
Primary
PSY22106
CA
Other
Enumeration date
10/27/2021
Last updated
11/06/2021
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