Active NPI
Courtney Tomblin
- Marriage & Family Therapist
- Diamond Springs, CA
National Provider Identifier
1154076560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 152087
- Practice address
- 493 Main St
Diamond Springs, CA 95619-9173 - Phone
- (530) 485-3374
- NPI assigned
- Feb 14, 2022
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 152087 | CA | Primary |
Addresses
Primary practice location
493 Main St
Diamond Springs, CA 95619-9173
Mailing address
4805 Golden Foothill Pkwy
El Dorado Hills, CA 95762-9651
Other practice location 1
4805 Golden Foothill Pkwy
El Dorado Hills, CA 95762-9651
Phone (530) 644-2412
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250521002801 | CA | Practitioner - Marriage and Family Therapist | 0143758359 | Practice locations: Diamond Springs, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
493 Pleasant Valley Rd
Suite 210 B
Diamond Springs, CA 95619-9173
Phone (530) 485-3374
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152087 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738800000000",
"number": "1154076560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4805 GOLDEN FOOTHILL PKWY",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957629651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "493 MAIN ST",
"city": "DIAMOND SPRINGS",
"state": "CA",
"postal_code": "956199173",
"telephone_number": "530-485-3374"
}
],
"practiceLocations": [
{
"address_1": "4805 Golden Foothill Pkwy",
"address_purpose": "LOCATION",
"city": "El Dorado Hills",
"state": "CA",
"postal_code": "957629651",
"country_code": "US",
"telephone_number": "530-644-2412",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TOMBLIN",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-14",
"last_updated": "2025-02-06",
"certification_date": "2025-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "152087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Diamond Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.