Individual provider Active NPI

Janette Diaz

  • Clinical Social Worker
  • Guadalupe, CA
National Provider Identifier
1972864296
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4723 W Main St Ste H
Guadalupe, CA 93434-1787
Phone
(805) 343-5577
Fax
(805) 343-5578
NPI assigned
Jun 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

4723 W Main St Ste H
Guadalupe, CA 93434-1787

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220621001257 CA Practitioner - Clinical Social Worker 5496134504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of the Central Coast IncGroup PAC ID 7416868120, 74 clinicians

Practice addresses (Care Compare)

4723 W Main St
Suite H
Guadalupe, CA 93434-1787
Phone (805) 343-5577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101491CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince May 2, 2022 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince May 2, 2022 Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients

Locations

4723 W Main St
Ste H
Guadalupe, CA 93434
Phone (805) 343-2004

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2801 Santa Maria Way
Bldg A
Santa Maria, CA 93455
Phone (805) 938-9200

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

Interoperability endpoints

  • Direct secure messaging: janette.diaz.1@17363.direct.athenahealth.com

Organizations & group practices 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1972864296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8030",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4723 W MAIN ST STE H",
            "city": "GUADALUPE",
            "state": "CA",
            "postal_code": "934341787",
            "telephone_number": "805-343-5577",
            "fax_number": "805-343-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "JANETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-04",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guadalupe, CA

Sources for this page

Verify at the official NPI Registry.