Provider Demographics
NPI:1760635601
Name:FRANKLIN, DIANA JV (RD)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:JV
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MISS
Other - First Name:DIANA
Other - Middle Name:J
Other - Last Name:VALLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:98-1005 MOANALUA RD SPC 420
Mailing Address - Street 2:CKD SERVICES OF PEARLRIDGE
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4702
Mailing Address - Country:US
Mailing Address - Phone:808-440-4893
Mailing Address - Fax:808-440-4885
Practice Address - Street 1:98-1005 MOANALUA RD SPC 420
Practice Address - Street 2:CKD SERVICES OF PEARLRIDGE
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4702
Practice Address - Country:US
Practice Address - Phone:808-440-4893
Practice Address - Fax:808-440-4885
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI808310133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIAZ366ZOtherPROVIDER TRANSACTION ACCESS NUMBER (PTAN)