Individual provider Active NPI

Diane Barbara Harris, MD

  • Psychiatry Physician
  • Fountain Valley, CA
National Provider Identifier
1225041023
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G51414 Issued in CA
Practice address
11770 Warner Avenue
Suite 127
Fountain Valley, CA 92708-2660
Phone
(714) 967-0660
NPI assigned
Aug 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G51414 CA Primary

Addresses

Primary practice location

11770 Warner Avenue
Suite 127
Fountain Valley, CA 92708-2660

Mailing address

11770 Warner Avenue
Suite 127
Fountain Valley, CA 92708-2660
Phone (714) 967-0660

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080220000264 CA Practitioner - Psychiatry 4183708845 Practice locations: Fountain Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, Irvine, California College of Medicine, 1982
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11770 Warner Ave
Suite 110
Fountain Valley, CA 92708-2659
Phone (714) 967-0660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G51414CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225041023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11770 WARNER AVENUE",
            "address_2": "SUITE 127",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082660",
            "telephone_number": "714-967-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11770 WARNER AVENUE",
            "address_2": "SUITE 127",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082660",
            "telephone_number": "714-967-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DIANE",
        "middle_name": "BARBARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G51414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.