Provider Demographics
NPI:1730386046
Name:RILEY, DIANA ELIZABETH (MPH, MS,PA-C)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:ELIZABETH
Last Name:RILEY
Suffix:
Gender:F
Credentials:MPH, MS,PA-C
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Mailing Address - Street 1:490 PERSIMMON CMN UNIT 14
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-6540
Mailing Address - Country:US
Mailing Address - Phone:925-786-1841
Mailing Address - Fax:
Practice Address - Street 1:5144 HILL RD E
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-6300
Practice Address - Country:US
Practice Address - Phone:707-263-8955
Practice Address - Fax:707-263-8340
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2023-05-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA16295363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant