Healthcare Provider Details

I. General information

NPI: 1386360774
Provider Name (Legal Business Name): DIAMENT WELLNESS MARRIAGE & COUNSELING, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 WINNCASTLE ST
SIMI VALLEY CA
93065-0619
US

IV. Provider business mailing address

516 WINNCASTLE ST
SIMI VALLEY CA
93065-0619
US

V. Phone/Fax

Practice location:
  • Phone: 805-558-5597
  • Fax:
Mailing address:
  • Phone: 818-519-2815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LITAL DIAMENT
Title or Position: OWNER
Credential: LMFT
Phone: 818-519-2815