Individual provider · NPI-1

Diana Groves

Registered Nurse, General Practice · Roseville, CA

NPI number1104550334
StatusActive
Last updated in NPPESJul 28, 2025

Details

NPI
1104550334
Entity type
Individual (NPI-1)
Name
Diana Groves
Sex
Female
Sole proprietor
No
Enumeration date
Jul 13, 2022
Certification date
Jul 28, 2025
Last updated
Jul 28, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice95396568CAYes
164X00000X Licensed Vocational Nurse720292CA

Practice location

1133 Coloma Way
Roseville, CA 95661-4480

Phone 916-774-6647

Mailing address

855 Howe Ave
Sacramento, CA 95825-3912

Is something wrong?

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