Provider Demographics
NPI:1780023804
Name:BIGNAMI, JACADI DIANE (MD)
Entity type:Individual
Prefix:
First Name:JACADI
Middle Name:DIANE
Last Name:BIGNAMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JACADI
Other - Middle Name:DIANE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 W LA VETA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3928
Mailing Address - Country:US
Mailing Address - Phone:805-252-4567
Mailing Address - Fax:
Practice Address - Street 1:805 W LA VETA AVE STE 101
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3928
Practice Address - Country:US
Practice Address - Phone:714-997-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA136277207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology