Provider Demographics
NPI:1740587716
Name:HAYASHINO, DIANE SUYEKO (PHD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:SUYEKO
Last Name:HAYASHINO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5724 E DEBORAH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1308
Mailing Address - Country:US
Mailing Address - Phone:949-293-2390
Mailing Address - Fax:
Practice Address - Street 1:5855 GREEN VALLEY CIR STE 202
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6968
Practice Address - Country:US
Practice Address - Phone:310-365-2934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-27
Last Update Date:2011-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21190103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist