Provider Demographics
NPI:1053845404
Name:VAUGHAN-JONES, DIANA (RN, PHN)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:VAUGHAN-JONES
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3158 CLAIREMONT DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6411
Mailing Address - Country:US
Mailing Address - Phone:808-298-3168
Mailing Address - Fax:
Practice Address - Street 1:3158 CLAIREMONT DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6411
Practice Address - Country:US
Practice Address - Phone:808-298-3168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA281770163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health