Diana Bortolus, SUDRC #13485

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

13485 Issued in CA

Practice address

2015 Pioneer CT
San Mateo, CA 94403-1781

Phone

(650) 348-6603

NPI assigned

Dec 11, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Healthright 360

  • Community/Behavioral Health Agency
  • San Mateo, CA
  • NPI 1649403486
  NPD (past)

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1144097916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 PIONEER CT STE B",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031736",
            "telephone_number": "650-348-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 PIONEER CT",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031781",
            "telephone_number": "650-348-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORTOLUS",
        "first_name": "DIANA",
        "credential": "SUDRC #13485",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "13485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Darling Borges
• Vitel Born, LMFT
• Harriet Beth Borofsky, M.D.
• Rachel Marie Borovina, MD
• Diana Borromeo
• Ariane Bosch, PA-C
• Dana Monica Bosso
• Boston Medical Group-California L.L.C.
• Telysa D Both
• Fouad Bou-Salman, OTR

• Addiction (Substance Use Disorder) Counselor in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.