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General NPI Number Information
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NPI Number | 1518177468
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Entity Type | Individual
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Provider Name | DIANE D. KAY M.S.W., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 205 AVENUE I SUITE 28
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City | REDONDO BEACH
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State | CA
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Zip | 90277-5619
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Country | US
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Telephone | 310-528-4050
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2744
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City | PALOS VERDES PENINSULA
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State | CA
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Zip | 90274-8744
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Country | US
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Telephone | 310-528-4050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS20612
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License Number State | CA
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