Provider Demographics
NPI:1285773093
Name:WORTHY, DIANA LYNN
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:WORTHY
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 1:720 S EUCLID ST STE 6
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-1530
Mailing Address - Country:US
Mailing Address - Phone:714-776-8757
Mailing Address - Fax:714-776-8758
Practice Address - Street 1:720 S EUCLID ST STE 6
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-1530
Practice Address - Country:US
Practice Address - Phone:714-776-8757
Practice Address - Fax:714-776-8758
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2305237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist