Healthcare Provider Details

I. General information

NPI: 1932042298
Provider Name (Legal Business Name): DIAMOND KNOX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1067 E 4TH ST APT 6
LONG BEACH CA
90802-1639
US

IV. Provider business mailing address

1067 E 4TH ST APT 6
LONG BEACH CA
90802-1639
US

V. Phone/Fax

Practice location:
  • Phone: 562-717-1228
  • Fax:
Mailing address:
  • Phone: 562-717-1228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number01311201
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: