Provider Demographics
NPI:1316417322
Name:CASTRO, DIANNA S (RN, MSN, NCSN)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:S
Last Name:CASTRO
Suffix:
Gender:F
Credentials:RN, MSN, NCSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10902 WHITBURN ST
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-5425
Mailing Address - Country:US
Mailing Address - Phone:310-839-6998
Mailing Address - Fax:
Practice Address - Street 1:4401 ELENDA ST
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4182
Practice Address - Country:US
Practice Address - Phone:310-842-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA568399163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool