Healthcare Provider Details

I. General information

NPI: 1053744508
Provider Name (Legal Business Name): ERICA YOSHIE DIAMANT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 6TH ST
BERKELEY CA
94710-2006
US

IV. Provider business mailing address

2031 6TH ST
BERKELEY CA
94710-2006
US

V. Phone/Fax

Practice location:
  • Phone: 510-813-1181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23456
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: