Provider Demographics
NPI:1316463615
Name:RAMIL, DIANA VERONICA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:VERONICA
Last Name:RAMIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:VERONICA
Other - Last Name:MADRIGAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42180 HIDEAWAY ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-2801
Mailing Address - Country:US
Mailing Address - Phone:760-409-0228
Mailing Address - Fax:
Practice Address - Street 1:42180 HIDEAWAY ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-2801
Practice Address - Country:US
Practice Address - Phone:760-409-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA825745163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$OtherSELF