Individual provider Active NPI

Diana Rozenoyer

  • Case Manager/Care Coordinator
  • Glendale, CA
National Provider Identifier
1740879501
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1800 Bel Aire Dr
Glendale, CA 91201-1446
Phone
(818) 572-6024
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1374790120 CA
Behavior Technician 106S00000X R1374790120 CA
Attendant Care Provider 3747A0650X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

1800 Bel Aire Dr
Glendale, CA 91201-1446

Mailing address

1800 Bel Aire Dr
Glendale, CA 91201-1446
Phone (818) 572-6024

Other practice location 1

1042 E Belmont Abbey Ln
Claremont, CA 91711-1463
Phone (909) 971-3333

Other identifiers 2

IdentifierTypeStateIssuer
621344OtherCAACCREDITATION FROM JOINT COMMISSION FOR BEHAVIORAL HEATH CARE PROGRAM
190939APOtherCALICENSE FROM DHCS

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.hathawayrecovery.com DESTINY RECOVERY INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R1374790120CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Destiny Recovery Inc CurrentSince Jan 17, 2021 Accepting new patients
Integrity Foundation Current Accepting new patients

Organizations & group practices 2

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": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1740879501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 BEL AIRE DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011446",
            "telephone_number": "818-572-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BEL AIRE DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011446",
            "telephone_number": "818-572-6024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1042 E Belmont Abbey Ln",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "CA",
            "postal_code": "917111463",
            "country_code": "US",
            "telephone_number": "909-971-3333",
            "fax_number": "909-498-9898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROZENOYER",
        "first_name": "DIANA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1374790120",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "R1374790120",
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCREDITATION FROM JOINT COMMISSION FOR BEHAVIORAL HEATH CARE PROGRAM",
            "identifier": "621344",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE FROM DHCS",
            "identifier": "190939AP",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.hathawayrecovery.com",
            "affiliation": "Y",
            "endpointDescription": "Website",
            "affiliationName": "DESTINY RECOVERY INC",
            "address_1": "1800 Bel Aire Dr",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912011446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.