Provider Demographics
NPI:1699503656
Name:CARRERA, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:CARRERA
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 1:13826 BECHARD AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-4427
Mailing Address - Country:US
Mailing Address - Phone:213-219-6021
Mailing Address - Fax:
Practice Address - Street 1:13826 BECHARD AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4427
Practice Address - Country:US
Practice Address - Phone:213-219-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-314495174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN