Provider Demographics
NPI:1861246225
Name:VALDEZ, DIANA S (ND)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:S
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9176 BLUE POINT LN APT 6
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-5349
Mailing Address - Country:US
Mailing Address - Phone:916-585-0084
Mailing Address - Fax:
Practice Address - Street 1:9176 BLUE POINT LN APT 6
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-5349
Practice Address - Country:US
Practice Address - Phone:916-585-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-1494175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath