Active NPI
Diane Edgemon, LE, CPE
- Point of Service
- Livermore, CA
National Provider Identifier
1043748544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Point of Service
- License
- L7180
- Practice address
- 60 Fenton St Ste 11
Livermore, CA 94550-4148 - Phone
- (925) 337-3522
- NPI assigned
- May 28, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Point of Service | 305S00000X | L7180 | CA | Primary |
Addresses
Primary practice location
60 Fenton St Ste 11
Livermore, CA 94550-4148
Mailing address
60 Fenton St Ste 11
Livermore, CA 94550-4148
Phone (925) 337-3522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L7180 | CA | MD | Point of Service |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495929600000",
"number": "1043748544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 FENTON ST STE 11",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945504148",
"telephone_number": "925-337-3522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 FENTON ST STE 11",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945504148",
"telephone_number": "925-337-3522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGEMON",
"first_name": "DIANE",
"name_prefix": "Ms.",
"credential": "LE, CPE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-28",
"last_updated": "2017-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "305S00000X",
"taxonomy_group": "",
"desc": "Point of Service",
"state": "CA",
"license": "L7180",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.