Individual provider Active NPI

Diana Uribe, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
National Provider Identifier
1346555158
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12720196-3501 Issued in UT
Practice address
515 S 700 E
Salt Lake City, UT 84102-2801
Phone
(385) 334-4840
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 86000 CA
Clinical Social Worker 1041C0700X 12720196-3501 UT Primary

Addresses

Primary practice location

515 S 700 E
Salt Lake City, UT 84102-2801

Mailing address

621 Park Shadow CT
Baldwin Park, CA 91706-3277
Phone (626) 622-1285

Other practice location 1

14307 S Vistaglen Loop
Houston, TX 77084-2174
Phone (626) 622-1285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201110000752 CA Practitioner - Clinical Social Worker 4587074117 Reassigns benefits to 2 organizations
I20230509003010 TX Practitioner - Clinical Social Worker 4587074117 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12720196-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mellow Medical Inc a Professional Corporation CurrentSince Sep 30, 2020 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Apr 5, 2023 Accepting new patients
Grow Healthcare Group PC Clinical CurrentSince Oct 20, 2022 Accepting new patients

Locations

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (888) 284-2779

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1346555158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 PARK SHADOW CT",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063277",
            "telephone_number": "626-622-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022801",
            "telephone_number": "385-334-4840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14307 S Vistaglen Loop",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770842174",
            "country_code": "US",
            "telephone_number": "626-622-1285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URIBE",
        "first_name": "DIANA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "86000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "12720196-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.