Individual provider Active NPI

Rebecca Elsie Diaz

  • Case Manager/Care Coordinator
  • San Diego, CA
National Provider Identifier
1609418979
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
995 Gateway Center Way Ste 300
San Diego, CA 92102-4550
Phone
(619) 398-2156
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

995 Gateway Center Way Ste 300
San Diego, CA 92102-4550

Mailing address

995 Gateway Center Way
San Diego, CA 92102-4500
Phone (619) 398-2156

Other practice location 1

891 Kuhn Dr Ste 110
Chula Vista, CA 91914-3551
Phone (619) 864-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1609418979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024500",
            "telephone_number": "619-398-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 GATEWAY CENTER WAY STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024550",
            "telephone_number": "619-398-2156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "891 Kuhn Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919143551",
            "country_code": "US",
            "telephone_number": "619-864-7070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "REBECCA",
        "middle_name": "ELSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.