Provider Demographics
NPI:1093121956
Name:PARKER, DIANE LOUISE (MA, SLP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:LOUISE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4727
Mailing Address - Country:US
Mailing Address - Phone:626-243-3167
Mailing Address - Fax:
Practice Address - Street 1:214 S ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3257
Practice Address - Country:US
Practice Address - Phone:626-863-1224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17664235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist