Provider Demographics
NPI:1932643251
Name:NGUYEN, DIANA TRAN (CNM)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:TRAN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 BLUEBELL PL
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-9040
Mailing Address - Country:US
Mailing Address - Phone:805-612-0702
Mailing Address - Fax:
Practice Address - Street 1:1122 N HARRIS ST STE 104
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3785
Practice Address - Country:US
Practice Address - Phone:559-582-1041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235853176B00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife