Diane Marie Goddard, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

256951 Issued in TX

Practice address

8122 Datapoint Dr Ste 1003
San Antonio, TX 78229-3273

Phone

(210) 261-1500

Fax

(210) 261-1837

NPI assigned

Oct 6, 2009

Last updated

Dec 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Diane Marie Friese Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1033444286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-287-4472",
            "fax_number": "210-261-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8122 DATAPOINT DR STE 1003",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293273",
            "telephone_number": "210-261-1500",
            "fax_number": "210-261-1837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "343 W Houston St",
            "address_2": "Suite 706",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782052107",
            "country_code": "US",
            "telephone_number": "210-225-0481",
            "fax_number": "210-223-1814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-06",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "256951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "FRIESE",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Gocare Home Health Services LLC
• God and Christ Care
• Traci-Lin Goddin, OD
• Jane Nolasco Godelia, LPC
• Kristen Godett, NURSE PRACTIONER
• Amanda Kim Godfrey, SLPA
• Lauren Godfrey

• Psychiatric/Mental Health Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.