Diana Elizabeth Tennyson, RN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

524262; 20960 Issued in CA

Practice address

12826 Philadelphia St
Suite a
Whittier, CA 90601-4117

Phone

(562) 789-9908

Fax

(562) 789-9418

NPI assigned

Oct 30, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Diana Elizabeth Judd Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1174877088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10837 CANELO RD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906041902",
            "telephone_number": "562-941-2292",
            "fax_number": "562-941-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12826 PHILADELPHIA ST",
            "address_2": "SUITE A",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014117",
            "telephone_number": "562-789-9908",
            "fax_number": "562-789-9418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNYSON",
        "first_name": "DIANA",
        "middle_name": "ELIZABETH",
        "credential": "RN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "524262; 20960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "JUDD",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Whittier, CA
• Providers in Whittier, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.