Diane Helen Peacock, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

403521 Issued in CA

Practice address

1019 S Danehurst Ave
Glendora, CA 91740-4855

Phone

(626) 963-9214

NPI assigned

Sep 21, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1700072873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 S DANEHURST AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404855",
            "telephone_number": "626-963-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 S DANEHURST AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404855",
            "telephone_number": "626-963-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "DIANE",
        "middle_name": "HELEN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "403521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathways 1 Sober Living
• Patriot DME Inc.
• Jamison Jon Pawley, DMD MS
• Jamie Danielle Payne, CATC-I
• PCC Health Services, Inc.
• Virginia Pena, M.S.-IP, B.A.
• Maria Haydee Perez-Melendez, MS
• Carolina Perez, LCSW
• Damaris Perez
• Leticia Jimenez Perez

• Registered Nurse in Glendora, CA
• Providers in Glendora, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.