Healthcare Provider Details

I. General information

NPI: 1528998812
Provider Name (Legal Business Name): DIANA SALAS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31600 PAT RD
WINCHESTER CA
92596-7800
US

IV. Provider business mailing address

29775 HAUN RD
MENIFEE CA
92586-6540
US

V. Phone/Fax

Practice location:
  • Phone: 951-325-6000
  • Fax:
Mailing address:
  • Phone: 951-672-1851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number285437
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: