Provider Demographics
NPI:1326125758
Name:DIAI, LAWRENCE
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:
Last Name:DIAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13725 CHADRON AVE APT 228
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-9210
Mailing Address - Country:US
Mailing Address - Phone:310-679-2614
Mailing Address - Fax:
Practice Address - Street 1:11539 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2325
Practice Address - Country:US
Practice Address - Phone:310-263-2155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health