Individual provider Active NPI

Diana Luz Marmolejo

  • Student in an Organized Health Care Education/Training Program
  • Riverside, CA
National Provider Identifier
1942009170
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3933 Harrison St
Riverside, CA 92503-3523
Phone
(833) 391-0505
NPI assigned
Mar 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3933 Harrison St
Riverside, CA 92503-3523

Mailing address

47800 Madison St Unit 145
Indio, CA 92201-6679
Phone (760) 844-5924

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

NPI Registry JSON

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1942009170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47800 MADISON ST UNIT 145",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016679",
            "telephone_number": "760-844-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3933 HARRISON ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033523",
            "telephone_number": "833-391-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMOLEJO",
        "first_name": "DIANA",
        "middle_name": "LUZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "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 Mar 11, 2025; 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.