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General NPI Number Information
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NPI Number | 1023516259
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Entity Type | Individual
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Provider Name | DIANA BAINBRIDGE CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 5201 GREAT AMERICA PKWY STE 320
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City | SANTA CLARA
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State | CA
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Zip | 95054-1140
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Country | US
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Telephone | 323-205-7088
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Fax | 833-419-0181
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Provider Business Mailing Address
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Address Line | 3535 MARKET ST STE 100
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City | PHILADELPHIA
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State | PA
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Zip | 19104-3376
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP018684
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95033007
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License Number State | CA
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