Doctor Name: | CHERRYL DIOM |
NPI Number: | 1003200833 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 795013 |
Business Practice Address: | 9808 Venice Blvd Ste. 505 Culver City, CA - 902322732 |
Business Phone Number: | 3109453350 |
Business Fax Number: | 3109453356 |
Mailing Address: | 9808 Venice Blvd, Ste. 505 CULVER CITY |
State: | CA |
Postal Code: | 902322732 |
Phone Number: | 3109453350 |
Fax Number: | 3109453356 |
NPI Enumeration Date: | 03/18/2015 |
NPI Last Update Date: | 03/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 795013 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |