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NPI Code Detail

MEDICARE: DIANA FUENTES

MEDICARE: DIANA FUENTES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language Assistant6650CA

General Provider Information

NPI Number : 1457283731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA FUENTES
Provider Business Mailing Address
First Line : 630 E 41ST PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-3125
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 223 N JACKSON ST
Second Line :
City : GLENDALE
State : CA
Zip : 91206-4334
Country : US
Telephone Number : 818-241-3111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ DIANA FUENTES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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