Active NPI
Diana Avalos
- Community Health Worker
- Redwood City, CA
National Provider Identifier
1063700151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 500 Allerton St
Redwood City, CA 94063-1519 - Phone
- (650) 599-9955
- NPI assigned
- Jul 11, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | RI-A1004152144 | CA | |
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
500 Allerton St
Redwood City, CA 94063-1519
Mailing address
PO Box 10501
San Jose, CA 95157-1501
Phone (714) 717-2963
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 |
|---|---|---|---|
| RI-A1004152144 | CA | MD | Substance Abuse Rehabilitation Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516838400000",
"number": "1063700151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10501",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951571501",
"telephone_number": "714-717-2963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 ALLERTON ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940631519",
"telephone_number": "650-599-9955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVALOS",
"first_name": "DIANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-11",
"last_updated": "2018-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "CA",
"license": "RI-A1004152144",
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.