Basic Information
Provider Information
NPI: 1790946135
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CURRY
FirstName: DIANE
MiddleName: RENEE
NamePrefix: MS.
NameSuffix:  
Credential: LVN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11426 HAYFORD ST
Address2:  
City: NORWALK
State: CA
PostalCode: 906506308
CountryCode: US
TelephoneNumber: 5628633534
FaxNumber: 5625652421
Practice Location
Address1: 2701 OCEAN PARK BLVD
Address2: SUITE 150B
City: SANTA MONICA
State: CA
PostalCode: 904055200
CountryCode: US
TelephoneNumber: 3103929474
FaxNumber: 3103927341
Other Information
ProviderEnumerationDate: 06/18/2008
LastUpdateDate: 06/18/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164X00000XVN157231CAY Nursing Service ProvidersLicensed Vocational Nurse 

No ID Information.


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