Individual
DIANA PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18700 OXNARD ST, TARZANA, CA 91356-1413
(818) 996-1051
Mailing address
18700 OXNARD ST, TARZANA, CA 91356-1413
(818) 996-1051
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-OBXDVU
CA
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912475203
MPSS-OBXDVU
CA
01
—
95-2633765
MED-CAL
CA
Enumeration date
11/05/2018
Last updated
05/23/2025
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