Healthcare Provider Details

I. General information

NPI: 1871460840
Provider Name (Legal Business Name): DIANA CHRISTINE HERELD PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 11/23/2025
Certification Date: 11/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 OVERLAND AVE APT 302
LOS ANGELES CA
90025-5895
US

IV. Provider business mailing address

1931 OVERLAND AVE APT 302
LOS ANGELES CA
90025-5895
US

V. Phone/Fax

Practice location:
  • Phone: 360-990-5283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY35684
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY35684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: