Active NPI
Diana Lorene Geronimo, LMFT
- Marriage & Family Therapist
- Eugene, OR
National Provider Identifier
1649793209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T1526
- Practice address
- 400 E 2ND Ave Ste 104E
Eugene, OR 97401-2452 - Phone
- (541) 357-7502
- NPI assigned
- Jul 25, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | T1526 | OR | Primary |
Addresses
Primary practice location
400 E 2ND Ave Ste 104E
Eugene, OR 97401-2452
Mailing address
789 Cherry Ave
Eugene, OR 97404-3192
Phone (541) 790-9261
Other practice location 1
3995 Marcola Rd
Springfield, OR 97477-7948
Phone (541) 726-1465
Other practice location 2
389 W 6th Ave
Eugene, OR 97401-2508
Phone (541) 357-7502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 30, 2026 through Apr 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T1526 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1649793209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "789 CHERRY AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974043192",
"telephone_number": "541-790-9261",
"fax_number": "541-357-7102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E 2ND AVE STE 104E",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012452",
"telephone_number": "541-357-7502"
}
],
"practiceLocations": [
{
"address_1": "3995 Marcola Rd",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "OR",
"postal_code": "974777948",
"country_code": "US",
"telephone_number": "541-726-1465",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "389 W 6th Ave",
"address_purpose": "LOCATION",
"city": "Eugene",
"state": "OR",
"postal_code": "974012508",
"country_code": "US",
"telephone_number": "541-357-7502",
"fax_number": "541-357-7102",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GERONIMO",
"first_name": "DIANA",
"middle_name": "LORENE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-25",
"last_updated": "2022-07-21",
"certification_date": "2021-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "T1526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.