Provider Demographics
NPI:1831865146
Name:PARKER, DIAJA (BS, RDMS, RVT)
Entity type:Individual
Prefix:
First Name:DIAJA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:BS, RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3870
Mailing Address - Country:US
Mailing Address - Phone:725-221-0589
Mailing Address - Fax:
Practice Address - Street 1:121 S CANAL ST STE B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5735
Practice Address - Country:US
Practice Address - Phone:725-221-0589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDMS004612471S1302X
NMVS002772471V0105X
CA1026632085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography