Provider Demographics
NPI:1649042623
Name:DIATTA, NDEYE MARIE (RN)
Entity type:Individual
Prefix:
First Name:NDEYE
Middle Name:MARIE
Last Name:DIATTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-4232
Mailing Address - Country:US
Mailing Address - Phone:213-258-5003
Mailing Address - Fax:
Practice Address - Street 1:2011 41ST AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-4232
Practice Address - Country:US
Practice Address - Phone:213-258-5003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95350776163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse