Individual provider Active NPI

Martha Diamond, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1285748723
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 11351 Issued in CA
Practice address
11777 Bernardo Plaza CT Ste 108
San Diego, CA 92128-2450
Phone
(858) 673-2131
Fax
(858) 451-3938
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
Yes

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
Clinical Psychologist 103TC0700X PSY 11351 CA Primary

Addresses

Primary practice location

11777 Bernardo Plaza CT Ste 108
San Diego, CA 92128-2450

Mailing address

11777 Bernardo Plaza CT Ste 108
San Diego, CA 92128-2450
Phone (858) 673-2131

Other identifiers 1

IdentifierTypeStateIssuer
PSY 11351OtherCAPHD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11351CAMDAddiction (Substance Use Disorder) Counselor
PSY 11351CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285748723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11777 BERNARDO PLAZA CT STE 108",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282450",
            "telephone_number": "858-673-2131",
            "fax_number": "858-451-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11777 BERNARDO PLAZA CT STE 108",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282450",
            "telephone_number": "858-673-2131",
            "fax_number": "858-451-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "MARTHA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 11351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHD",
            "identifier": "PSY 11351",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.