Healthcare Provider Details

I. General information

NPI: 1891401428
Provider Name (Legal Business Name): DIANNE NICON NARCISE SARMIENTO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WESTWOOD BLVD
LOS ANGELES CA
90024-5608
US

IV. Provider business mailing address

1700 WESTWOOD BLVD
LOS ANGELES CA
90024-5608
US

V. Phone/Fax

Practice location:
  • Phone: 310-592-5233
  • Fax:
Mailing address:
  • Phone: 310-592-5233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95021693
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95021693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: