Healthcare Provider Details

I. General information

NPI: 1659604577
Provider Name (Legal Business Name): DIANA ALEXANDRA LERNER F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2009
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3816 WOODRUFF AVE
LONG BEACH CA
90808-2147
US

IV. Provider business mailing address

731 SILK TREE
IRVINE CA
92606-4512
US

V. Phone/Fax

Practice location:
  • Phone: 562-496-4749
  • Fax:
Mailing address:
  • Phone: 949-230-3768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: