Provider Demographics
NPI:1497009658
Name:PASH, DIANA M (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:M
Last Name:PASH
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CORPORATE POINTE
Mailing Address - Street 2:SUITE A4000
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7615
Mailing Address - Country:US
Mailing Address - Phone:424-443-8548
Mailing Address - Fax:
Practice Address - Street 1:400 CORPORATE POINTE
Practice Address - Street 2:SUITE A4000
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-7615
Practice Address - Country:US
Practice Address - Phone:424-443-8548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93944106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01261511Medicaid