Healthcare Provider Details

I. General information

NPI: 1265367858
Provider Name (Legal Business Name): SARAH DIETZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7721 HILLSMERE CIR
HIGHLAND CA
92346-5731
US

IV. Provider business mailing address

7721 HILLSMERE CIR
HIGHLAND CA
92346-5731
US

V. Phone/Fax

Practice location:
  • Phone: 909-800-6701
  • Fax: 909-800-6701
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number824293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: