Individual provider Active NPI

Diana Serratos, LVN

  • Licensed Vocational Nurse
  • Riverside, CA
National Provider Identifier
1164106589
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN728037 Issued in CA
Practice address
3700 Quartz Canyon Rd SPC 10
Riverside, CA 92509-1112
Phone
(909) 638-8054
NPI assigned
Jun 14, 2023
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN728037 CA Primary

Addresses

Primary practice location

3700 Quartz Canyon Rd SPC 10
Riverside, CA 92509-1112

Mailing address

3700 Quartz Canyon Rd SPC 10
Riverside, CA 92509-1112
Phone (909) 638-8054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
VN728037CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1164106589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 QUARTZ CANYON RD SPC 10",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925091112",
            "telephone_number": "909-638-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 QUARTZ CANYON RD SPC 10",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925091112",
            "telephone_number": "909-638-8054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRATOS",
        "first_name": "DIANA",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN728037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.