MEDICARE: DIANA ANGIE ACOSTA

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	20486	CA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1528600871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA ANGIE ACOSTA

Provider Business Mailing Address
First Line	:	222 S HILL ST STE 600
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-3523
Country	:	US
Telephone Number	:	213-255-9753
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 S HILL ST STE 600222S
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-3506
Country	:	US
Telephone Number	:	213-255-9753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	06/18/2026

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Directions to “ DIANA ANGIE ACOSTA ” Practice Location

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