Individual
DIAMOND BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11762 DE PALMA RD STE C, CORONA, CA 92883-4011
(909) 442-2741
Mailing address
11762 DE PALMA ROAD, SUITE C #1056, CORONA, CA 92883-5829
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
CPT02042174
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02042174
LICENSE NUMBER
CA
01
—
NONE
NONE
—
Enumeration date
03/01/2021
Last updated
09/01/2021
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