Gerardo Jose Diaz, AMFT# 136318

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

136318 Issued in CA

Practice address

455 1St St
Woodland, CA 95695-4023

Phone

(530) 662-2211

Fax

(530) 758-8490

NPI assigned

May 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1245720366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 1ST ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956954023",
            "telephone_number": "530-662-2211",
            "fax_number": "530-758-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 1ST ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956954023",
            "telephone_number": "530-662-2211",
            "fax_number": "530-758-8490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3550 Watt Ave Ste 140",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958212666",
            "country_code": "US",
            "telephone_number": "530-383-3835",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1811 Grand Canal Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952078107",
            "country_code": "US",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "GERARDO",
        "middle_name": "JOSE",
        "credential": "AMFT# 136318",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "136318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Demille, LPT
• Krista Lina Dezerega-Thomson, O.T.
• Gurbir Singh Dhaliwal
• Kumerpreet Kaur Dhaliwal
• Rajpreet S Dhesi, MD
• Jose Gerardo Diaz
• Manuel Carlos Diaz Jr., D.O.
• Maria Diaz
• Tracey Dickinson
• Dignity Community Care

• Marriage & Family Therapist in Woodland, CA
• Providers in Woodland, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.