Healthcare Provider Details

I. General information

NPI: 1487115291
Provider Name (Legal Business Name): DIANA YASMIN ARELLANO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2521 STOCKTON BLVD
SACRAMENTO CA
95817-2207
US

IV. Provider business mailing address

2801 43RD ST
SACRAMENTO CA
95817-3034
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-0494
  • Fax: 916-734-4958
Mailing address:
  • Phone: 805-890-8357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number95117963
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: