Andrew Donald Dertien

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1410691120 Issued in CA

Practice address

1111 Market St FL 1
San Francisco, CA 94103-1589

Phone

(415) 863-3883

NPI assigned

Dec 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1013512383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032543",
            "telephone_number": "415-762-3700",
            "fax_number": "415-865-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MARKET ST FL 1",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031589",
            "telephone_number": "415-863-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERTIEN",
        "first_name": "ANDREW",
        "middle_name": "DONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-03",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1410691120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Derochi, MSW
• Stacy Marie Derosa, R.D.
• Lesje Derose, MD
• Allyson Kate Derossett, OT
• Daniel Derrick
• Paul M Dertien
• Molyan Hiett Dery, CRNA
• Amar Ashok Desai, M.D.
• Arjun M Desai, M.D.
• Arpita Desai, M.D.

• Addiction (Substance Use Disorder) Counselor in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.