Individual provider Active NPI

Diana Mirela Botezan, M.D.

  • Psychiatry Physician
  • Bakersfield, CA
National Provider Identifier
1245264589
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A87854 Issued in CA
Practice address
1830 Flower St
Suite 144
Bakersfield, CA 93305-4144
Phone
(661) 326-2248
Fax
(661) 872-3366
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 A87854 CA Primary

Addresses

Primary practice location

1830 Flower St
Suite 144
Bakersfield, CA 93305-4144

Mailing address

1830 Flower St
Suite 144
Bakersfield, CA 93305-4144
Phone (661) 326-2248

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
I20051117000922 CA Practitioner - Psychiatry 3577582683 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A87854CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians CurrentSince May 30, 2020 Accepting new patients
Pih Health Physicians CurrentSince May 30, 2020 Accepting new patients
Pih Health Physicians Current Accepting new patients
Kern Faculty Surgical Group PastSince Jul 1, 2004 Accepting new patients

Locations

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

12291 Washington Blvd
Ste 300
Whittier, CA 90606
Phone (562) 945-7252

Organizations & group practices 4

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1245264589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 FLOWER ST",
            "address_2": "SUITE 144",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933054144",
            "telephone_number": "661-326-2248",
            "fax_number": "661-872-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 FLOWER ST",
            "address_2": "SUITE 144",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933054144",
            "telephone_number": "661-326-2248",
            "fax_number": "661-872-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTEZAN",
        "first_name": "DIANA",
        "middle_name": "MIRELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A87854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.