NPIMap

Organization Active NPI

Diabetes Society

  • Health Educator
  • San Jose, CA
National Provider Identifier
1326065160
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
DIABETES SOCIETY
Practice address
1165 Lincoln Ave
#300
San Jose, CA 95125-3038
Phone
(408) 287-3785
Fax
(408) 287-2701
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Authorized official

Name
Mrs. Carol D Kassouf
Title
Executive Director
Phone
(510) 331-8620

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
Registered Dietetic TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 136A00000X
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X Primary

Addresses

Primary practice location

1165 Lincoln Ave
#300
San Jose, CA 95125-3038

Mailing address

1165 Lincoln Ave
#300
San Jose, CA 95125-3038
Phone (408) 287-3785

National Provider Directory

National Provider Directory

Locations

1165 Lincoln Ave
Ste 300
San Jose, CA 95125
Phone (408) 287-3785

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1326065160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 LINCOLN AVE",
            "address_2": "#300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253038",
            "telephone_number": "408-287-3785",
            "fax_number": "408-287-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 LINCOLN AVE",
            "address_2": "#300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253038",
            "telephone_number": "408-287-3785",
            "fax_number": "408-287-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES SOCIETY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "KASSOUF",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "510-331-8620",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietetic Technician, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.