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1649773920
DIANE T ROQUE
GLENDALE, CA
NPI
1649773920
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95008440)
Enumeration Date
2018-03-13
Last Update Date
2018-03-13
Business Address
DIANE T ROQUE
710 S CENTRAL AVE STE 330
GLENDALE, CA 91204-4647
Phone number: 818-263-5737
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Mailing Address
DIANE T ROQUE
119 N ARDMORE AVE
LOS ANGELES, CA 90004-4501
Phone number: 818-263-5737
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