Provider Demographics
NPI:1770060352
Name:DIALA, JOYCE CHIMEZIEM
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:CHIMEZIEM
Last Name:DIALA
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 1:4295 AMAPOLA WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5049
Mailing Address - Country:US
Mailing Address - Phone:916-389-0656
Mailing Address - Fax:
Practice Address - Street 1:4295 AMAPOLA WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5049
Practice Address - Country:US
Practice Address - Phone:916-389-0656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator