Diversified Intervention Group

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

DIVERSIFIED INTERVENTION GROUP

Practice address

309 Sequoia St
Morro Bay, CA 93442-1409

Phone

(805) 602-0681

NPI assigned

Jun 21, 2014

Last updated

Jun 21, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Edward Allen Salan

Title

Founding Director

Phone

(805) 602-0681

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403308800000",
    "number": "1396150074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 SEQUOIA ST",
            "city": "MORRO BAY",
            "state": "CA",
            "postal_code": "934421409",
            "telephone_number": "805-602-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SEQUOIA ST",
            "city": "MORRO BAY",
            "state": "CA",
            "postal_code": "934421409",
            "telephone_number": "805-602-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED INTERVENTION GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-21",
        "last_updated": "2014-06-21",
        "status": "A",
        "authorized_official_last_name": "SALAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "FOUNDING DIRECTOR",
        "authorized_official_telephone_number": "805-602-0681",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire V. Cuevas, PHARM.D.
• Julie Nicole Datter, RADT
• Gretchen Daulman
• Alan De Vera, PT, DPT
• Kristin Rachelle Dejong, TECHNICIAN HEALTH
• Richard Lincoln Donald V, RADT
• Natalia Donici
• Deborah Ilealoha Dover, P.T.
• Ross J. Dover, P.T.
• Mary Ellen Ehman, FNP

• Case Management Agency in Morro Bay, CA
• Providers in Morro Bay, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2014; 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.