Provider Demographics
NPI:1639354400
Name:DEMARA, DALIA KARINA (HIGH SCHOOL DIPLOMA)
Entity Type:Individual
Prefix:
First Name:DALIA
Middle Name:KARINA
Last Name:DEMARA
Suffix:
Gender:F
Credentials:HIGH SCHOOL DIPLOMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 S PLYMOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-6835
Mailing Address - Country:US
Mailing Address - Phone:323-930-7845
Mailing Address - Fax:
Practice Address - Street 1:20930 BONITA ST
Practice Address - Street 2:SUITE Y
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3680
Practice Address - Country:US
Practice Address - Phone:310-532-3464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-29
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)