Healthcare Provider Details

I. General information

NPI: 1790946135
Provider Name (Legal Business Name): DIANE RENEE CURRY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5199 E PACIFIC COAST HWY STE 330N
LONG BEACH CA
90804-3353
US

IV. Provider business mailing address

11426 HAYFORD ST
NORWALK CA
90650-6308
US

V. Phone/Fax

Practice location:
  • Phone: 562-365-2020
  • Fax: 562-239-3135
Mailing address:
  • Phone: 562-863-3534
  • Fax: 562-565-2421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95025040
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN157231
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: