Provider Demographics
NPI:1275954448
Name:DIACHENKO, ZHANNA S (L ACU, RN)
Entity Type:Individual
Prefix:
First Name:ZHANNA
Middle Name:S
Last Name:DIACHENKO
Suffix:
Gender:F
Credentials:L ACU, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S LAKE ST
Mailing Address - Street 2:#106
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2400
Mailing Address - Country:US
Mailing Address - Phone:818-433-4655
Mailing Address - Fax:
Practice Address - Street 1:700 S LAKE ST
Practice Address - Street 2:#106
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2400
Practice Address - Country:US
Practice Address - Phone:818-433-4655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15086171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist