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General NPI Number Information
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NPI Number | 1528110327
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Entity Type | Individual
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Provider Name | DIANNA LEAH COSTA R.N., F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2025 MORSE AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-2115
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Country | US
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Telephone | 916-973-6391
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Fax | 916-973-5981
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Provider Business Mailing Address
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Address Line | 4500 RIGEL CT
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City | SHINGLE SPRINGS
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State | CA
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Zip | 95682-5011
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Country | US
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Telephone | 530-676-7481
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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 | 213917
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License Number State | CA
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