Dean Alexander Presley, CA LICENSE NO. L9737

Primary specialty

SpecialistTaxonomy code 174400000X

License

L9737 Issued in CA

Practice address

384 Jackson St Ste 3
Hayward, CA 94544-1556

Phone

(415) 209-8698

NPI assigned

Dec 7, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lois M Presley Former name

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": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1053022319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 JACKSON ST STE 3",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441556",
            "telephone_number": "415-209-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 JACKSON ST STE 3",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441556",
            "telephone_number": "415-209-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESLEY",
        "first_name": "DEAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "CA LICENSE NO. L9737",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "L9737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOIS",
            "last_name": "PRESLEY",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Specialist in Hayward, CA
• Providers in Hayward, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.