Healthcare Provider Details

I. General information

NPI: 1508353988
Provider Name (Legal Business Name): DIANA PALMARIO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2018
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31170 TEMECULA PKWY STE 100
TEMECULA CA
92592-2915
US

IV. Provider business mailing address

35179 HULIHEE ST
WINCHESTER CA
92596-8515
US

V. Phone/Fax

Practice location:
  • Phone: 951-698-6090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95005085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: