Provider Demographics
NPI:1972717965
Name:DIAMOND, VIRGINIA HEITMAN (CCP)
Entity type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:HEITMAN
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 PALO ALTO AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1217
Mailing Address - Country:US
Mailing Address - Phone:650-566-0225
Mailing Address - Fax:650-566-0225
Practice Address - Street 1:426 PALO ALTO AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-1217
Practice Address - Country:US
Practice Address - Phone:650-566-0225
Practice Address - Fax:650-566-0225
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA780103242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist