NPIMap

Organization Active NPI

Psychnp Consultants, Inc

Doing business as Diamond House Detox

  • Substance Abuse Rehabilitation Facility
  • Elk Grove, CA
National Provider Identifier
1538528716
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
340111AP Issued in CA
Legal business name
PSYCHNP CONSULTANTS, INC
Doing business as
Diamond House Detox
Practice address
8624 Diamond Oak Way
Elk Grove, CA 95624-1755
Phone
(800) 205-6107
Fax
(916) 760-4435
NPI assigned
Feb 17, 2016
Last updated
May 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Authorized official

Name
Vicky Magobet, PMHNPNPI 1902243827
Title
Owner/President
Phone
(916) 633-8353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 340111AP CA Primary

Addresses

Primary practice location

8624 Diamond Oak Way
Elk Grove, CA 95624-1755

Mailing address

8624 Diamond Oak Way
Elk Grove, CA 95624-1755
Phone (800) 205-6107

Other names 1

  • Diamond House Detox Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2136149Diamond House Detox8624 Diamond Oak Way, Elk Grove, CA 95624Certificate of waiverSep 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Diamond House Detox5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1538528716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8624 DIAMOND OAK WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241755",
            "telephone_number": "800-205-6107",
            "fax_number": "916-760-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8624 DIAMOND OAK WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241755",
            "telephone_number": "800-205-6107",
            "fax_number": "916-760-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHNP CONSULTANTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "MAGOBET",
        "authorized_official_first_name": "VICKY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "916-633-8353",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "340111AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diamond House Detox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.