Nathaniel Custodio Diwa

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95040283 Issued in CA

Practice address

2779 Linde Vista Dr
Rialto, CA 92377-3417

Phone

(702) 205-0073

NPI assigned

Jun 27, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1782518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782518400000",
    "number": "1487570016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2779 LINDE VISTA DR",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923773417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2779 LINDE VISTA DR",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923773417",
            "telephone_number": "702-205-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIWA",
        "first_name": "NATHANIEL",
        "middle_name": "CUSTODIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-27",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95040283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Rialto, CA
• Providers in Rialto, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2026; 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.