Patricia Diefenbach, ND, CNS, CPT

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Practice address

6907 Brimstone LN
Fairfax Station, VA 22039-1819

Phone

(703) 609-8717

NPI assigned

Apr 24, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Natural Integrative Healthcare

  • Naturopath
  • Fairfax Station, VA
  • NPI 1427443670
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1003203258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MOUNT VERNON AVE STE 206",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223011302",
            "telephone_number": "703-609-8717",
            "fax_number": "703-239-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6907 BRIMSTONE LN",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220391819",
            "telephone_number": "703-609-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEFENBACH",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "ND, CNS, CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "DC",
            "license": "0053",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CT",
            "license": "000538",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clinical Therapy Services
• Stephen R Connor, PHD
• Ellen M Courtney
• Marjorie Guerrero Cruz, RN
• Deana Demare Hally
• Discovery Practice Management, Inc
• Jamie Michelle Durkovic, MS
• Lisa Anne Eidelkind, LCSW
• Fereshteh Ejtemai, PHARMACIST
• Donna Esmaeili

• Nutrition Education Nutritionist in Fairfax Station, VA
• Providers in Fairfax Station, VA by specialty
• Nutrition Education Nutritionist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.