Provider Demographics
NPI:1245071570
Name:DIEGO, PRECIOUS JOY T
Entity type:Individual
Prefix:
First Name:PRECIOUS JOY
Middle Name:T
Last Name:DIEGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1134 KAHUAHALE ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3503
Mailing Address - Country:US
Mailing Address - Phone:808-589-8728
Mailing Address - Fax:808-200-5054
Practice Address - Street 1:94-1134 KAHUAHALE ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3503
Practice Address - Country:US
Practice Address - Phone:808-589-8728
Practice Address - Fax:808-200-5054
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-91590163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse