Healthcare Provider Details

I. General information

NPI: 1679181366
Provider Name (Legal Business Name): DIANA ROBLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 W CHAPMAN AVE
ORANGE CA
92868-2647
US

IV. Provider business mailing address

401 E 61ST ST
LOS ANGELES CA
90003-1620
US

V. Phone/Fax

Practice location:
  • Phone: 949-989-6932
  • Fax: 949-989-7608
Mailing address:
  • Phone: 323-821-6891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: