Diane Mascarenas

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

32200 Issued in CA

Practice address

11741 Telegraph Rd
Santa Fe Springs, CA 90670-3681

Phone

(562) 942-8256

Fax

(562) 949-3587

NPI assigned

Oct 17, 2017

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)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Ontario, CA
  • NPI 1902273923
  NPD (past)

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1447761465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11741 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11741 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703681",
            "telephone_number": "562-942-8256",
            "fax_number": "562-949-3587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCARENAS",
        "first_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "32200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167G00000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Martinez
• Monica Elena Martinez
• Norma Martinez, B.A.
• Patricia Adriana Martinez
• Ray Martinez, MFTI
• Ana Mata
• Matthew Mata
• Amanda Dawn Mathews
• Antonio Matinez Sr.
• Matix Diabetic, Inc

• Licensed Psychiatric Technician in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.