Diane Meloche Justusson, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11038302 Issued in FL

Practice address

4115 W Spruce St Ste 205
Tampa, FL 33607-2485

Phone

(239) 999-1029

Fax

(617) 807-0958

NPI assigned

Oct 2, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in HI, DC, OR3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: diane.justusson.p1@direct.lanecounty.nextgenshare.com

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.

• Kalihi Palama Health Center

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1457304966
  Medicare reassignment NPD
• Lane County Oregon

  • Federally Qualified Health Center (FQHC)
  • Springfield, OR
  • NPI 1326138314
  Medicare reassignment NPD
• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  DC

  Medicare reassignment NPD
• Kalihi Palama Health Center

  • Federally Qualified Health Center (FQHC)
  • Honolulu, HI
  • NPI 1235908831
  NPD

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1114178688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87-1048 HUAMOA ST",
            "city": "WAIANAE",
            "state": "HI",
            "postal_code": "967923435",
            "telephone_number": "808-375-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 W SPRUCE ST STE 205",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072485",
            "telephone_number": "239-999-1029",
            "fax_number": "617-807-0958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87-1048 Huamoa St",
            "address_purpose": "LOCATION",
            "city": "Waianae",
            "state": "HI",
            "postal_code": "967923435",
            "country_code": "US",
            "telephone_number": "808-375-7317",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "86-260 Farrington Hwy",
            "address_2": "ATTN: CREDENTIALING",
            "address_purpose": "LOCATION",
            "city": "Waianae",
            "state": "HI",
            "postal_code": "967923128",
            "country_code": "US",
            "telephone_number": "808-697-3517",
            "fax_number": "808-697-3687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUSTUSSON",
        "first_name": "DIANE",
        "middle_name": "MELOCHE",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "HI",
            "license": "1433",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "HI",
            "license": "1433",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11038302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Just Like My Home Too, LLC
• Mary Sandra B. Justen, MSP, CCC-SLP
• Mario Juster Kruse, MHC - LP
• Justin Family a.L.F. LLC
• Jennifer Justo, PTA
• JX Marketing
• Jyh Services Corp
• K & N Home Care Agency LLC
• K One Laboratory LLC
• K&J Caregiver Services Inc

• Psychiatric/Mental Health Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.