Provider Demographics
NPI:1689564783
Name:VIGURI, DIANA RUTH (SUD COUNSELOR)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:RUTH
Last Name:VIGURI
Suffix:
Gender:F
Credentials:SUD COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 LANKERSHIM BLVD SPC 15
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-0003
Mailing Address - Country:US
Mailing Address - Phone:714-213-6296
Mailing Address - Fax:
Practice Address - Street 1:8250 LANKERSHIM BLVD SPC 15
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-0003
Practice Address - Country:US
Practice Address - Phone:714-213-6296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YP2500X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional