Diane I. Harris, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G44893 Issued in CA

Practice address

850 Sequoia Cir
Fort Bragg, CA 95437-5490

Phone

(707) 964-0259

Fax

(707) 964-0765

NPI assigned

Aug 11, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1386656312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SEQUOIA CIR",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375490",
            "telephone_number": "707-964-0259",
            "fax_number": "707-964-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SEQUOIA CIR",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375490",
            "telephone_number": "707-964-0259",
            "fax_number": "707-964-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DIANE",
        "middle_name": "I.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G44893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00G448930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gretchen Hahn, LMFT
• Amelia Hanney, DDS
• Happy Rides Inc.
• Happy Rides LLC
• Crystal Marie Harris, LCSW
• Elizabeth Hayes Harvey
• Emily Jasmine Head, LAC, MAOM
• Arwen Hebden
• Elaine Heine
• Larry Ira Heiss, MD

• Family Medicine Physician in Fort Bragg, CA
• Providers in Fort Bragg, 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 Nov 2, 2015; 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.