Provider Demographics
NPI:1649734286
Name:LOPEZ, DIANA ZAYURI
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:ZAYURI
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 E 9TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2429
Mailing Address - Country:US
Mailing Address - Phone:626-324-4045
Mailing Address - Fax:
Practice Address - Street 1:539 E 9TH ST APT 3
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2429
Practice Address - Country:US
Practice Address - Phone:626-324-4045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst