Individual provider Active NPI

Deirdre Mary Demorest, PH.D.

  • Clinical Psychologist
  • Santa Clara, CA
National Provider Identifier
1013223981
Registry record updated Aug 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 13669 Issued in CA
Practice address
1588 Homestead Rd
Suite 6
Santa Clara, CA 95050-4783
Phone
(408) 246-1100
Fax
(408) 984-0135
NPI assigned
Aug 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 13669 CA Primary

Addresses

Primary practice location

1588 Homestead Rd
Suite 6
Santa Clara, CA 95050-4783

Mailing address

1588 Homestead Rd
Suite 6
Santa Clara, CA 95050-4783
Phone (408) 246-1100

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 13669CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1283040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283040000000",
    "number": "1013223981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1588 HOMESTEAD RD",
            "address_2": "SUITE 6",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504783",
            "telephone_number": "408-246-1100",
            "fax_number": "408-984-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1588 HOMESTEAD RD",
            "address_2": "SUITE 6",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504783",
            "telephone_number": "408-246-1100",
            "fax_number": "408-984-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMOREST",
        "first_name": "DEIRDRE",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-29",
        "last_updated": "2010-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 13669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2010; 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.