Individual
DIANNE CAMILLE CEA MALLARI-REQUILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6105 WADDINGTON WAY, ROSEVILLE, CA 95747-4550
(510) 512-8275
Mailing address
6105 WADDINGTON WAY, ROSEVILLE, CA 95747-4550
(510) 512-8275
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95038941
CA
Other
Enumeration date
03/12/2026
Last updated
03/12/2026
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