Provider Demographics
NPI:1821418450
Name:KATSMA, DIANE (DNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:KATSMA
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2761 E MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-4429
Mailing Address - Country:US
Mailing Address - Phone:209-648-1512
Mailing Address - Fax:
Practice Address - Street 1:2761 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4429
Practice Address - Country:US
Practice Address - Phone:209-648-1512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA334471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily