Active NPI
Diana Vallarta Koroi, LM, CPM
- Midwife
- San Jose, CA
National Provider Identifier
1053604058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- LM303
- Practice address
- 967 W. Hedding St
Ste 110
San Jose, CA 95126 - Phone
- (408) 886-4961
- Fax
- (408) 412-5020
- NPI assigned
- May 24, 2011
- 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 |
|---|---|---|---|---|
| Midwife | 176B00000X | LM303 | CA | Primary |
Addresses
Primary practice location
967 W. Hedding St
Ste 110
San Jose, CA 95126
Mailing address
PO Box 2179
Los Gatos, CA 95031
Phone (408) 886-4961
Other names 1
- Diana Renee Vallarta
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 |
|---|---|---|---|
| LM303 | CA | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1053604058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2179",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "95031",
"telephone_number": "408-886-4961",
"fax_number": "408-412-5020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "967 W. HEDDING ST",
"address_2": "STE 110",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95126",
"telephone_number": "408-886-4961",
"fax_number": "408-412-5020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOROI",
"first_name": "DIANA",
"middle_name": "VALLARTA",
"credential": "LM, CPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-24",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "LM303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIANA",
"last_name": "VALLARTA",
"middle_name": "RENEE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.