Provider Demographics
NPI:1700259835
Name:RIOS, DIANA S (NP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:S
Last Name:RIOS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:23326 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3725
Mailing Address - Country:US
Mailing Address - Phone:310-257-7205
Mailing Address - Fax:310-598-3119
Practice Address - Street 1:824 E CARSON ST
Practice Address - Street 2:SUITE 203
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2262
Practice Address - Country:US
Practice Address - Phone:310-233-3203
Practice Address - Fax:310-316-5318
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2015-11-12
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Provider Licenses
StateLicense IDTaxonomies
CANP95003265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily