Active NPI
Diana L Fresquez, MA-LICENSED
- Professional Counselor
- Alamosa, CO
National Provider Identifier
1275768277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5103
- Practice address
- 315 State Ave
Alamosa, CO 81101-2637 - Phone
- (719) 588-8885
- NPI assigned
- May 19, 2009
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5103 | CO | Primary |
Addresses
Primary practice location
315 State Ave
Alamosa, CO 81101-2637
Mailing address
315 State Ave
Alamosa, CO 81101-2637
Phone (719) 588-8885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
720 S Colorado Blvd
PH North
Denver, CO 80246-1904
Phone (844) 843-7279
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5103 | CO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Professional | Current | Accepting new patients |
Locations
720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589
Organizations & group practices 1
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": "1242691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337126400000",
"number": "1275768277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 STATE AVE",
"city": "ALAMOSA",
"state": "CO",
"postal_code": "811012637",
"telephone_number": "719-588-8885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 STATE AVE",
"city": "ALAMOSA",
"state": "CO",
"postal_code": "811012637",
"telephone_number": "719-588-8885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRESQUEZ",
"first_name": "DIANA",
"middle_name": "L",
"credential": "MA-LICENSED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-19",
"last_updated": "2012-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "5103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alamosa, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.