Active NPI
Evelyn Joan Diccianni III
- Case Manager/Care Coordinator
- San Diego, CA
National Provider Identifier
1154535680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 3020 Childrens Way
MC 6013
San Diego, CA 92123-4223 - Phone
- (619) 576-1700
- Fax
- (619) 420-5531
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
3020 Childrens Way
MC 6013
San Diego, CA 92123-4223
Mailing address
6746 Boulder Lake Ave
San Diego, CA 92119-1903
Phone (619) 644-5706
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rady Children'S Hospital and Health Center | Past | Accepting new patients | |
| Rady Children'S Hospital San Diego | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Children's Hospital
- San Diego, CA
- NPI 1770799108
-
- Children's Hospital
- Chula Vista, CA
- NPI 1457666802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154535680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6746 BOULDER LAKE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921191903",
"telephone_number": "619-644-5706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY",
"address_2": "MC 6013",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "619-576-1700",
"fax_number": "619-420-5531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICCIANNI",
"first_name": "EVELYN",
"middle_name": "JOAN",
"name_prefix": "Mrs.",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"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.