Diana Maria Prince, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A63605 Issued in CA

Practice address

1450 Medical Center Dr
Suite 3
Rohnert Park, CA 94928-2924

Phone

(707) 584-8588

Fax

(707) 584-2869

NPI assigned

Aug 18, 2006

Last updated

Dec 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• Santa Rosa Community Health Centers

  dba Vista Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1578631172
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800

  Family Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Santa Rosa Community Health Centers

  dba Caritas Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1467180430
  NPD
• Santa Rosa Community Health Centers

  dba Elsie Allen Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1871651273
  NPD
• Primary Care Associates of the Redwood Empire Medical Group, Inc.

  • Family Medicine Physician
  • Santa Rosa, CA
  • NPI 1245348820
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1316051501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 MEDICAL CENTER DR",
            "address_2": "SUITE 3",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282924",
            "telephone_number": "707-584-8588",
            "fax_number": "707-584-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MEDICAL CENTER DR",
            "address_2": "SUITE 3",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282924",
            "telephone_number": "707-584-8588",
            "fax_number": "707-584-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "DIANA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A63605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5900 State Farm Dr",
            "city": "Rohnert Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949282149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Desiree Pooley, CMT
• Kristin Popadak, OTR/L
• Ermal Grace Kathleen Powell, L.AC, DACM
• Katie Pratt
• Lynne Marie Prieto
• Kathy Louise Principi, M.D.
• Protransport 1
• Elisa Pujals, M.D.
• Yareli Madelin Pulido
• Anne Marie Purdy, APRN

• Family Medicine Physician in Rohnert Park, CA
• Providers in Rohnert Park, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.