Individual
MRS. DIANDRA CORAL BECENTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2300 E 30TH ST BLDG D, FARMINGTON, NM 87401-8990
(505) 327-1400
(505) 564-3202
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2009-0009
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15375862
—
NM
01
—
202037772
PHP
—
01
—
9592385
AETNA
—
01
—
PA2009-0009
NM LICENSE
NM
Enumeration date
06/03/2009
Last updated
05/19/2026
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