Individual provider Active NPI

Diana Bush, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange, CA
National Provider Identifier
1104472174
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95021382 Issued in CA
Practice address
1100 W Town and Country Rd Ste 1232
Orange, CA 92868-4600
Phone
(714) 817-7447
NPI assigned
Aug 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 828188 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95021382 CA Primary

Addresses

Primary practice location

1100 W Town and Country Rd Ste 1232
Orange, CA 92868-4600

Mailing address

1100 W Town and Country Rd Ste 1250
Orange, CA 92868-4633
Phone (714) 817-7447

Other practice location 1

473 E Carnegie Dr #200
San Bernardino, CA 92408
Phone (714) 817-7447

Other practice location 2

555 W 5th St Fl 35
Los Angeles, CA 90013-1010
Phone (714) 410-6588

Other practice location 3

650 California St Fl 7
San Francisco, CA 94108-2737
Phone (714) 410-6588

Other practice location 4

9920 Pacific Heights Blvd Ste 150
San Diego, CA 92121-4361
Phone (714) 410-6588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
828188CAMDRegistered Nurse
95021382CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Psychiatric/Mental Health CurrentSince Jul 24, 2024 Accepting new patients
Peter Pham Nursing Corporation Psychiatric/Mental Health CurrentSince May 1, 2023 Accepting new patients
Southa-Bush Nursing Corp Psychiatric/Mental Health CurrentSince Dec 28, 2025 Accepting new patients

Locations

1100 W Town and Country Rd
Ste 1239
Orange, CA 92868
Phone (714) 451-4880

1100 W Town and Country Rd
Ste 1232
Orange, CA 92868
Phone (714) 817-7447

1100 W Town and Country Rd
Ste 1250
Orange, CA 92868
Phone (657) 339-2799

9920 Pacific Heights Blvd
Ste 150
San Diego, CA 92121
Phone (855) 559-7433

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

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": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1104472174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1250",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684633",
            "telephone_number": "714-817-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W TOWN AND COUNTRY RD STE 1232",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684600",
            "telephone_number": "714-817-7447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "473 E Carnegie Dr #200",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "92408",
            "country_code": "US",
            "telephone_number": "714-817-7447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 W 5th St Fl 35",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900131010",
            "country_code": "US",
            "telephone_number": "714-410-6588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 California St Fl 7",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941082737",
            "country_code": "US",
            "telephone_number": "714-410-6588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9920 Pacific Heights Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921214361",
            "country_code": "US",
            "telephone_number": "714-410-6588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSH",
        "first_name": "DIANA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "828188",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.