Active NPI
Diane Rene Fisher, LMFT
- Marriage & Family Therapist
- Newport Beach, CA
National Provider Identifier
1942955976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 126826
- Practice address
- 1400 Quail St Ste 255
Newport Beach, CA 92660-2714 - Phone
- (949) 415-4710
- NPI assigned
- Feb 17, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 126826 | CA | Primary |
Addresses
Primary practice location
1400 Quail St Ste 255
Newport Beach, CA 92660-2714
Mailing address
17 Egret LN
Aliso Viejo, CA 92656-1760
Phone (949) 235-4711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 19, 2024 through Jun 19, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126826 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658707200000",
"number": "1942955976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 EGRET LN",
"city": "ALISO VIEJO",
"state": "CA",
"postal_code": "926561760",
"telephone_number": "949-235-4711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 QUAIL ST STE 255",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602714",
"telephone_number": "949-415-4710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "DIANE",
"middle_name": "RENE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-17",
"last_updated": "2022-07-25",
"certification_date": "2022-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "126826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.