Provider Demographics
NPI:1790176543
Name:DE VOS-SCHMIDT, DIANE (FNP-C)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:DE VOS-SCHMIDT
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 1:1551 BISHOP ST STE A110
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4692
Mailing Address - Country:US
Mailing Address - Phone:805-548-8585
Mailing Address - Fax:805-548-8589
Practice Address - Street 1:1551 BISHOP ST STE A110
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4692
Practice Address - Country:US
Practice Address - Phone:805-548-8585
Practice Address - Fax:805-548-8589
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001895363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health