Active NPI
Mariah Amanda Diaz
- Community Health Worker
- Santa Ana, CA
National Provider Identifier
1376285221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 600 W Santa Ana Blvd
Santa Ana, CA 92701-4558 - Phone
- (714) 953-4455
- NPI assigned
- Apr 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | AMFT139292 | CA | |
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
600 W Santa Ana Blvd
Santa Ana, CA 92701-4558
Mailing address
525 Cabrillo Park Dr Ste 300
Santa Ana, CA 92701-5017
Phone (714) 953-4455
Other practice location 1
525 Cabrillo Park Dr Ste 300
Santa Ana, CA 92701-5017
Phone (714) 953-4455
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT139292 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1376285221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 CABRILLO PARK DR STE 300",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927015017",
"telephone_number": "714-953-4455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 W SANTA ANA BLVD",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927014558",
"telephone_number": "714-953-4455"
}
],
"practiceLocations": [
{
"address_1": "525 Cabrillo Park Dr Ste 300",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927015017",
"country_code": "US",
"telephone_number": "714-953-4455",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIAZ",
"first_name": "MARIAH",
"middle_name": "AMANDA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-11",
"last_updated": "2023-11-15",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "AMFT139292",
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.