Provider Demographics
NPI:1508646829
Name:DIMAANO, KAREN KATE COLLO (FNP-C)
Entity Type:Individual
Prefix:
First Name:KAREN KATE
Middle Name:COLLO
Last Name:DIMAANO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7972 BELLFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-2208
Mailing Address - Country:US
Mailing Address - Phone:310-482-9653
Mailing Address - Fax:
Practice Address - Street 1:7972 BELLFLOWER DR
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-2208
Practice Address - Country:US
Practice Address - Phone:310-482-9653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95110193163W00000X
CAF08231097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse