# MARY JANE DIAZ VICENTE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1992294490
- **Gender:** F
- **Credential:** RN, CNOR, RNFA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 624580 | CA | — |
| 163WM0102X | Maternal Newborn Registered Nurse | 624580 | CA | — |
| 163WR0006X | Registered Nurse First Assistant | 000000 | CA | Yes |
| 163WX0003X | Inpatient Obstetric Registered Nurse | 624580 | CA | — |
| 364SP2800X | Perioperative Clinical Nurse Specialist | 1677682 | CA | — |

## Other

- **Enumeration date:** 05/09/2018
- **Last updated:** 05/09/2018