Active NPI
Diane Liberto Davis, MSN, FNP
- Family Nurse Practitioner
- San Diego, CA
National Provider Identifier
1114998184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 9671
- Practice address
- Box 153
San Diego, CA 92136-5153 - Phone
- (619) 556-8475
- NPI assigned
- Jan 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9671 | CA | Primary |
Addresses
Primary practice location
Box 153
San Diego, CA 92136-5153
Mailing address
PO Box 182208
Coronado, CA 92178-2208
Phone (619) 556-8475
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
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9671 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114998184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 182208",
"city": "CORONADO",
"state": "CA",
"postal_code": "921782208",
"telephone_number": "619-556-8475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BOX 153",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921365153",
"telephone_number": "619-556-8475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DIANE",
"middle_name": "LIBERTO",
"name_prefix": "Ms.",
"credential": "MSN, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "9671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.