Individual provider Active NPI

Yoojeong Kim Diamant, NP

  • Family Nurse Practitioner
  • Travis Afb, CA
National Provider Identifier
1306475033
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95011826 Issued in CA
Practice address
60 MDG/SGXF
101 Bodin Circle
Travis Afb, CA 94535-1809
Phone
(707) 423-5819
NPI assigned
Apr 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95011826 CA Primary

Addresses

Primary practice location

60 MDG/SGXF
101 Bodin Circle
Travis Afb, CA 94535-1809

Mailing address

60 MDG/SGXF
101 Bodin Circle
Travis Afb, CA 94535-1809

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220110000129 CA Practitioner - Nurse Practitioner 7012309735 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95011826CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group Current Accepting new patients
Northbay Healthcare Group CurrentSince Dec 1, 2024 Accepting new patients

Locations

1305 Stratford Ave
Dixon, CA 95620

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

101 Bodin Cir
Travis AFB, CA 94535
Phone (707) 423-3000

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

1679 E Monte Vista Ave
Ste 104
Vacaville, CA 95688
Phone (707) 624-7400

Organizations & group practices 2

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": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1306475033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MDG/SGXF",
            "address_2": "101 BODIN CIRCLE",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MDG/SGXF",
            "address_2": "101 BODIN CIRCLE",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMANT",
        "first_name": "YOOJEONG",
        "middle_name": "KIM",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-04",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95011826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.