Diana Grace Reyes De Leon

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95018486 Issued in CA

Practice address

12376 Twilight Ave
Sylmar, CA 91342-5161

Phone

(818) 648-0248

NPI assigned

Nov 15, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1043976970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12376 TWILIGHT AVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913425161",
            "telephone_number": "818-648-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12376 TWILIGHT AVE",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913425161",
            "telephone_number": "818-648-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "DIANA",
        "middle_name": "GRACE REYES",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95018486",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95062138",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adriana De la Cruz Campa
• Vanessa Stephanie De la Rosa Dominguez
• Alejandro De la Rosa
• Adriana Carolina De la Torre, LCSW
• Angelito Bustamante De Leon, PT
• Serene De Leon, FNP-C
• Dexter Alejandro De Vera
• Stanley Kwan Dea, M.D.
• Joanna V. Dearlove, M.D.
• Brian Decal

• Primary Care Nurse Practitioner in Sylmar, CA
• Providers in Sylmar, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.