Individual provider Active NPI

Diane Marie Waters, LCSW

  • Social Worker
  • Riverside, CA
National Provider Identifier
1578775011
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCS 23656 Issued in CA
Practice address
19322 Jesse LN
Riverside, CA 92508-5072
Phone
(951) 387-4040
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCS 23656 CA Primary

Addresses

Primary practice location

19322 Jesse LN
Riverside, CA 92508-5072

Mailing address

4164 Brockton Ave
Riverside, CA 92501-3400
Phone (951) 683-5193

Other names 1

  • Diane Marie Garcia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200217000994 CA Practitioner - Clinical Social Worker 4880021690 Reassigns benefits to 1 organization
I20250703000538 CA Practitioner - Marriage and Family Therapist 4880021690 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 23656CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Talk Therapy Center Social Worker CurrentSince Jun 20, 2025 Accepting new patients

Locations

19322 Jesse Ln
Ste 200
Riverside, CA 92508
Phone (951) 387-4040

19322 Jesse Ln
Riverside, CA 92508
Phone (951) 387-4040

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1578775011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4164 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013400",
            "telephone_number": "951-683-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19322 JESSE LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925085072",
            "telephone_number": "951-387-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCS 23656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "GARCIA",
            "middle_name": "MARIE",
            "credential": "B.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.