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General NPI Number Information
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NPI Number | 1710870563
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Entity Type | Individual
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Provider Name | FLORICEL T. OLIVA-DIZON NP
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Gender | Female
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 2315 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-2201
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Country | US
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Telephone | 916-703-6140
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Fax |
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Provider Business Mailing Address
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Address Line | 9693 DARLEY WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-4032
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Country | US
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Telephone | 916-320-7441
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | NP95031908
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License Number State | CA
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