Individual
MARY JANE DIAZ VICENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNOR, RNFA
Contact information
Practice address
2400 E 4TH ST, NATIONAL CITY, CA 91950-2026
(619) 470-4240
(619) 470-4400
Mailing address
2200 MOUNTAIN RIDGE RD, CHULA VISTA, CA 91914-2002
(619) 300-1201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
624580
CA
163WM0102X
Maternal Newborn Registered Nurse
624580
CA
163WR0006X
Registered Nurse First Assistant
Primary
000000
CA
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
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