Individual provider Active NPI

Diane Birgit Prosser, MFT

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1164731964
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
101YM0800X Issued in CA
Practice address
5090 N College Ave Apt 113
Fresno, CA 93704-2609
Phone
(831) 917-7993
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 101YM0800X CA Primary
Marriage & Family Therapist 106H00000X 21767 CA

Addresses

Primary practice location

5090 N College Ave Apt 113
Fresno, CA 93704-2609

Mailing address

5090 N College Ave Apt 113
Fresno, CA 93704-2609
Phone (831) 917-7993

Other identifiers 2

IdentifierTypeStateIssuer
21767OtherCABBS
N4429037OtherCADRIVERS LICENSE NUMBER

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240908000090 CA Practitioner - Marriage and Family Therapist 7113467937 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101YM0800XCAMDCounselor
21767CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno County CurrentSince Nov 24, 2024 Accepting new patients
Fresno County CurrentSince Nov 3, 2024 Accepting new patients
County of Fresno CurrentSince Jun 27, 2024 Accepting new patients
County of Fresno CurrentSince Jun 27, 2024 Accepting new patients

Locations

4441 E Kings Canyon Rd
Fresno, CA 93702
Phone (559) 453-4099

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1164731964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5090 N COLLEGE AVE APT 113",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042609",
            "telephone_number": "831-917-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5090 N COLLEGE AVE APT 113",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042609",
            "telephone_number": "831-917-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSSER",
        "first_name": "DIANE",
        "middle_name": "BIRGIT",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101YM0800X",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "21767",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBS",
            "identifier": "21767",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE NUMBER",
            "identifier": "N4429037",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.