Provider Demographics
NPI:1760277768
Name:NEAL, DIAMOND NICOLE (HOME HEATH CARE)
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:NICOLE
Last Name:NEAL
Suffix:
Gender:
Credentials:HOME HEATH CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 S MANSFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-3560
Mailing Address - Country:US
Mailing Address - Phone:323-690-9359
Mailing Address - Fax:
Practice Address - Street 1:2609 S MANSFIELD AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-3560
Practice Address - Country:US
Practice Address - Phone:323-690-9359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA002366600253Z00000X
CA00888132376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No253Z00000XAgenciesIn Home Supportive Care