Provider Demographics
NPI:1255690954
Name:SHER, DIANE (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:
Last Name:SHER
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:MRS
Other - First Name:DIANE
Other - Middle Name:D
Other - Last Name:SHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA,CCC-SLP
Mailing Address - Street 1:8011 BERGER PL
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7974
Mailing Address - Country:US
Mailing Address - Phone:310-823-7316
Mailing Address - Fax:
Practice Address - Street 1:3521 LOMITA BLVD
Practice Address - Street 2:SUITE201
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5039
Practice Address - Country:US
Practice Address - Phone:310-856-8528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP2774235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist