Individual
MS. DIANA GRACE REYES DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12376 TWILIGHT AVE, SYLMAR, CA 91342-5161
(818) 648-0248
Mailing address
12376 TWILIGHT AVE, SYLMAR, CA 91342-5161
(818) 648-0248
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95062138
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95018486
CA
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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