Provider Demographics
NPI:1760170468
Name:PARRA, DIANA A (CD/PDT (MG))
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:A
Last Name:PARRA
Suffix:
Gender:F
Credentials:CD/PDT (MG)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:837 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-1631
Mailing Address - Country:US
Mailing Address - Phone:951-733-3207
Mailing Address - Fax:
Practice Address - Street 1:837 ELM AVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-1631
Practice Address - Country:US
Practice Address - Phone:951-733-3207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula