Jacquez, Diane Marie

Jacquez, Diane Marie is an sole proprietor health care provider with primary practice located at 8318 Bella Vista Dr , Rancho Cucamonga CA 91701-1332. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Jacquez, Diane Marie can be contacted via phone (909) 466-9944.

Contact Information

Primary practice address
8318 Bella Vista Dr Rancho Cucamonga CA 91701-1332
Phone: (909) 466-9944
Fax: (909) 466-9944
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 397229 California

Profile Details

NPI number 1992895288
LBN Legal business name Jacquez, Diane Marie
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 15th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992895288 NPPES
California Other RVN003010 MEDI-CAL
California Other EPS014670 MEDI-CAL

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