Active NPI
Diane Katherine Dameron, LMFT
- Marriage & Family Therapist
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 27112
- 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
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 | 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 27112 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Coast Psychiatric Associates Inc | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.