Kate Diasamidze

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

36132 Issued in CA

Practice address

940 S Coast Dr Ste 225
Costa Mesa, CA 92626-7757

Phone

(949) 743-1457

NPI assigned

Nov 26, 2018

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

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

Specialty

Clinical Psychologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Julia Evans PHD Psychology PCGroup PAC ID 0446510309, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Julia Evans PHD Psychology PC

  dba Brain Wellness Institute

  • Clinical Psychologist
  • Costa Mesa, CA
  • NPI 1861902280

  Clinical Neuropsychologist

  Medicare reassignment Care Compare group NPD
• Kate Diasamidze PSYD Psychology PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sherman Oaks, CA
  • NPI 1124985155
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1568932242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 S COAST DR STE 225",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 S COAST DR STE 225",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267757",
            "telephone_number": "949-743-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIASAMIDZE",
        "first_name": "KATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "36132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Cameron Butler Dewilde, LCSW
• Tarlan Ariana Dewing, M.D.
• Miloni Manish Dharod
• Laurel Elizabeth Di Lorenzo
• Thomas Joseph Diamant, MD
• Aidan Rene Diaz
• Alejandro Diaz
• Arturo Diaz Jr., LCSW
• Brandy Alexandra Diaz
• David Michael Diaz, D.D.S.

• Clinical Neuropsychologist in Costa Mesa, CA
• Providers in Costa Mesa, 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 10, 2026; 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.
• 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.