Healthcare Provider Details

I. General information

NPI: 1508702788
Provider Name (Legal Business Name): DIANA VO PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8843 TWEEDY LN
DOWNEY CA
90240-2710
US

IV. Provider business mailing address

9932 NEWCASTLE AVE
WESTMINSTER CA
92683-5715
US

V. Phone/Fax

Practice location:
  • Phone: 714-202-7424
  • Fax:
Mailing address:
  • Phone: 714-467-7868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number54819
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: