Individual provider Active NPI

Diana Anzaldua

  • Social Worker
  • Austin, TX
National Provider Identifier
1053958801
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
64519 Issued in TX
Practice address
111 Ramble LN Ste 120
Austin, TX 78745-2281
Phone
(512) 270-8215
NPI assigned
Nov 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 64519 TX Primary

Addresses

Primary practice location

111 Ramble LN Ste 120
Austin, TX 78745-2281

Mailing address

111 Ramble LN Ste 120
Austin, TX 78745-2281
Phone (512) 270-8215

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Austin

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
64519TXMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma Therapy Center Current Accepting new patients
Contigo Wellness Foundation Current Accepting new patients

Locations

111 Ramble Ln
Ste 120
Austin, TX 78745
Phone (512) 222-9605

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1053958801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 RAMBLE LN STE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787452281",
            "telephone_number": "512-270-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 RAMBLE LN STE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787452281",
            "telephone_number": "512-270-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANZALDUA",
        "first_name": "DIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "64519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Austin",
            "affiliation": "N",
            "address_1": "111 Ramble Ln Ste 120",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787452281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.