Provider Demographics
NPI:1720795990
Name:LLORICO, DIANA LYN (RN, BSN, CCM)
Entity Type:Individual
Prefix:MS
First Name:DIANA LYN
Middle Name:
Last Name:LLORICO
Suffix:
Gender:F
Credentials:RN, BSN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 W CATALPA AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-3405
Mailing Address - Country:US
Mailing Address - Phone:714-307-2632
Mailing Address - Fax:
Practice Address - Street 1:2060 W CATALPA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-3405
Practice Address - Country:US
Practice Address - Phone:714-307-2632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA759861163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management