Individual provider Active NPI

David J Diamond, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1720192164
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY10871 Issued in CA
Practice address
11777 Bernardo Plaza CT Ste 108
San Diego, CA 92128-2450
Phone
(858) 673-2131
Fax
(858) 451-3938
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY10871 CA Primary

Addresses

Primary practice location

11777 Bernardo Plaza CT Ste 108
San Diego, CA 92128-2450

Mailing address

11777 Bernardo Plaza CT Ste 108
San Diego, CA 92128-2450
Phone (858) 673-2131

Other identifiers 1

IdentifierTypeStateIssuer
PSY 10871OtherCAPHD

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
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11777 Bernardo Plaza CT
Suite 108
San Diego, CA 92128-2450
Phone (858) 673-2131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1720192164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11777 BERNARDO PLAZA CT STE 108",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282450",
            "telephone_number": "858-673-2131",
            "fax_number": "858-451-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11777 BERNARDO PLAZA CT STE 108",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282450",
            "telephone_number": "858-673-2131",
            "fax_number": "858-451-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY10871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHD",
            "identifier": "PSY 10871",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.