Healthcare Provider Details

I. General information

NPI: 1265212799
Provider Name (Legal Business Name): DIANA MALOUF LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3685 MOTOR AVE STE 220
LOS ANGELES CA
90034-5746
US

IV. Provider business mailing address

3685 MOTOR AVE STE 220
LOS ANGELES CA
90034-5746
US

V. Phone/Fax

Practice location:
  • Phone: 323-393-3133
  • Fax:
Mailing address:
  • Phone: 323-393-3133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number162698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: