Provider Demographics
NPI:1003053307
Name:HAVILL, DIANA LOWRY (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:LOWRY
Last Name:HAVILL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6200 CANOGA AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7782
Mailing Address - Country:US
Mailing Address - Phone:818-528-6165
Mailing Address - Fax:866-405-2221
Practice Address - Street 1:6200 CANOGA AVE STE 350
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-7782
Practice Address - Country:US
Practice Address - Phone:818-528-6165
Practice Address - Fax:818-405-2221
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2020-03-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ524252084P0800X
MDD00684252084P0800X
CA1674862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty