Active NPI
Amy Dias
- School Psychologist
- Lodi, CA
National Provider Identifier
1821574229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 210109942
- Practice address
- 2375 Giannoni Way
Lodi, CA 95242-4795 - Phone
- (209) 331-8391
- NPI assigned
- Jul 18, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 210109942 | CA | Primary |
Addresses
Primary practice location
2375 Giannoni Way
Lodi, CA 95242-4795
Mailing address
1305 E Vine St
Lodi, CA 95240-3179
Phone (209) 331-7000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 210109942 | CA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1821574229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 E VINE ST",
"city": "LODI",
"state": "CA",
"postal_code": "952403179",
"telephone_number": "209-331-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2375 GIANNONI WAY",
"city": "LODI",
"state": "CA",
"postal_code": "952424795",
"telephone_number": "209-331-8391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAS",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-18",
"last_updated": "2024-07-26",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "210109942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.