Individual provider Active NPI

Diane Katherine Dameron, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1710294707
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
27112 Issued in CA
Practice address
10815 Rancho Bernardo Rd Ste 380
San Diego, CA 92127-5724
Phone
(858) 279-1223
NPI assigned
Sep 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 27112 CA Primary

Addresses

Primary practice location

10815 Rancho Bernardo Rd Ste 380
San Diego, CA 92127-5724

Mailing address

10815 Rancho Bernardo Rd Ste 380
San Diego, CA 92127-5724

Other practice location 1

2525 Camino Del Rio S
Suite 315
San Diego, CA 92108-3717
Phone (619) 280-3430 ext. 152

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240506003360 CA Practitioner - Marriage and Family Therapist 5991145013 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27112CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Mar 23, 2024 Accepting new patients

Locations

8881 Fletcher Pkwy
Ste 350
La Mesa, CA 91942
Phone (619) 465-9792

10815 Rancho Bernardo Rd
Ste 380
San Diego, CA 92127

8989 Rio San Diego Dr
Ste 200
San Diego, CA 92108
Phone (858) 357-5375

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

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": "1284249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1710294707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10815 RANCHO BERNARDO RD STE 380",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 RANCHO BERNARDO RD STE 380",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275724",
            "telephone_number": "858-279-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Camino Del Rio S",
            "address_2": "Suite 315",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083717",
            "country_code": "US",
            "telephone_number": "619-280-3430 x152",
            "fax_number": "619-280-5420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMERON",
        "first_name": "DIANE",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-12",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "27112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.