Active NPI
Diane Patricia Siegel, PH.D.
- Clinical Child & Adolescent Psychologist
- Los Alamitos, CA
National Provider Identifier
1700978095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PSY16202
- Practice address
- 10951 Cherry St
Suite 201
Los Alamitos, CA 90720-2401 - Phone
- (562) 799-8553
- NPI assigned
- Sep 28, 2006
- 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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY16202 | CA | Primary |
Addresses
Primary practice location
10951 Cherry St
Suite 201
Los Alamitos, CA 90720-2401
Mailing address
10951 Cherry St
Suite 201
Los Alamitos, CA 90720-2401
Phone (562) 799-8553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2018 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16202 | CA | MD | Clinical Child & Adolescent Psychologist |
| 16202 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327363200000",
"number": "1700978095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10951 CHERRY ST",
"address_2": "SUITE 201",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907202401",
"telephone_number": "562-799-8553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10951 CHERRY ST",
"address_2": "SUITE 201",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907202401",
"telephone_number": "562-799-8553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEGEL",
"first_name": "DIANE",
"middle_name": "PATRICIA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2012-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY16202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamitos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.