Individual provider Active NPI

Diane Camurat, LMFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1821452434
Registry record updated Apr 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
81394 Issued in CA
Practice address
1821 4TH St
Santa Rosa, CA 95404-3202
Phone
(707) 791-9018
NPI assigned
Apr 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2016

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 81394 CA Primary

Addresses

Primary practice location

1821 4TH St
Santa Rosa, CA 95404-3202

Mailing address

PO Box 211
Santa Rosa, CA 95402-0211
Phone (707) 791-9018

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.
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
81394CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460160000000",
    "number": "1821452434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954020211",
            "telephone_number": "707-791-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043202",
            "telephone_number": "707-791-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMURAT",
        "first_name": "DIANE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-09",
        "last_updated": "2016-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "81394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.