Provider Demographics
NPI:1477626521
Name:DIAMREYAN, FLORA ELOHO (FNP)
Entity Type:Individual
Prefix:MRS
First Name:FLORA
Middle Name:ELOHO
Last Name:DIAMREYAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:FLORA
Other - Middle Name:ELOHO
Other - Last Name:DIAMREYAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:FLORA DIAMREYAN PO BOX 475
Mailing Address - Street 2:
Mailing Address - City:ETIWANDA
Mailing Address - State:CA
Mailing Address - Zip Code:91739
Mailing Address - Country:US
Mailing Address - Phone:909-463-6077
Mailing Address - Fax:
Practice Address - Street 1:8599 HAVEN AVE STE 101
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-466-8888
Practice Address - Fax:909-483-0164
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15729363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner