Individual provider Active NPI

Gabriela Diaz

  • Psychologist
  • Morehead, KY
National Provider Identifier
1487026910
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
174842 Issued in KY
Practice address
411 Bishop CT
Morehead, KY 40351
Phone
(606) 784-2096
NPI assigned
Oct 23, 2015
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 174842 KY Primary

Addresses

Primary practice location

411 Bishop CT
Morehead, KY 40351

Mailing address

411 Bishop CT
Morehead, KY 40351-1009
Phone (606) 784-2096

Other names 1

  • Gabriela Alshafie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240426001465 CA Practitioner - Clinical Psychologist 4385084177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

22 W 39TH Ave
Hos316Ms
San Mateo, CA 94403-4364

222 W 39TH Ave
San Mateo, CA 94403-4364

2710 Middlefield Rd
Redwood City, CA 94063-3404
Phone (650) 573-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
174842KYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Mar 12, 2024 Accepting new patients
County of San Mateo CurrentSince Feb 20, 2024 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Feb 20, 2024 Accepting new patients
Commonwealth Behavioral Health & Counseling Past Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1487026910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 BISHOP CT",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511009",
            "telephone_number": "606-784-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BISHOP CT",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "40351",
            "telephone_number": "606-784-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "GABRIELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "174842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELA",
            "last_name": "ALSHAFIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morehead, KY

Sources for this page

Verify at the official NPI Registry.