Diana Kimberly Avary Fallon, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT116501 Issued in CA

Practice address

832 Sunny Glen Court
San Pablo, CA 94806-6113

Phone

(650) 714-4993

NPI assigned

Jan 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Diana Kimberly Avary Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1710527916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 SUNNY GLEN COURT",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948066113",
            "telephone_number": "650-714-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 SUNNY GLEN COURT",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948066113",
            "telephone_number": "650-714-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "DIANA",
        "middle_name": "KIMBERLY AVARY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT116501",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT116501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "AVARY",
            "middle_name": "KIMBERLY",
            "credential": "MA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• John Ergino, PHARMD
• Elber Escalante Vargas, FNP-C
• Jeremy Dean Eshom
• Jennifer Nicole Espinoza, MSN, APRN, FNP-C
• Karen Grace Fran Esteban
• Anntheia Yvonne Farr
• Charles Fernandez
• Janik Ferreira - Ward
• Victoria Fidel, RAS
• Michael Dennis Fidler, M.D.

• Marriage & Family Therapist in San Pablo, CA
• Providers in San Pablo, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.