Dyan Adinamis, LMFT
Individual provider Active NPI Marriage & Family Therapist · San Jose, CA
NPI 1134714744 · NPPES record last updated Mar 5, 2021
Key facts
- NPI
- 1134714744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 105229 (CA)
- Practice address
- 1190 S Bascom Ave Ste 216
San Jose, CA 95128-3512 - Phone
- (408) 912-5081
- NPI assigned
- Mar 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240329002247 | CA | Practitioner - Marriage and Family Therapist | 7517305386 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105229 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PC | Marriage & Family Therapist | Current |
Accepting new patients |
| Cyti Health PC | Current |
Accepting new patients |
Locations
11801 Pierce St
Ste 200
Riverside, CA 92505
Phone (323) 547-2662
11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317
3111 Camino del Rio N
Ste 460
San Diego, CA 92108
402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 105229 | CA | Yes |
Addresses
Primary practice location
1190 S Bascom Ave Ste 216
San Jose, CA 95128-3512
Mailing address
PO Box 111381
Campbell, CA 95011-1381
Phone (408) 398-5378
Other providers in San Jose, CA
- Amina Hersi Aden
- Adham Zooby
- Sushil Adhikari
- Adi-Op, Inc.
- Nina Adib
- Joanne Adkins
- Neil Samuel Adler
- Ruth Admasu
- Snehal Adodra
- Shanel Adolfo
All providers in San Jose, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.