Diane Holland Engelman, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY11457 Issued in NU

Practice address

1044 Sir Francis Drake Blvd Ste 4
Kentfield, CA 94904-1454

Phone

(415) 721-7382

Fax

(415) 721-7448

NPI assigned

Apr 25, 2011

Last updated

Apr 25, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1437440476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 SIR FRANCIS DRAKE BLVD STE 4",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041454",
            "telephone_number": "415-721-7382",
            "fax_number": "415-721-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 SIR FRANCIS DRAKE BLVD STE 4",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041454",
            "telephone_number": "415-721-7382",
            "fax_number": "415-721-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELMAN",
        "first_name": "DIANE",
        "middle_name": "HOLLAND",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": "PSY11457",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY11457",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Driscoll, PH.D.
• Lael Conway Duncan, MD
• Roberta C Duncan, MFT
• John Weston Egbert, DPT
• Ariel Elkins, BA, BS, MSN, FNP
• Jason Sasha Ewbank
• Bert Faerstein, PH.D.
• Balakimwe Farara
• Fedrigo Podiatry a Professional Corporation
• Fedrigo Podiatry, Apc

• Clinical Neuropsychologist in Kentfield, CA
• Providers in Kentfield, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.