Individual provider Active NPI

B.Melissa Derfler, MD

  • Psychiatry Physician
  • Arroyo Grande, CA
National Provider Identifier
1053472373
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G57007 Issued in CA
Practice address
1057 Grand Ave
Arroyo Grande, CA 93420-2504
Phone
(805) 481-7220
Fax
(805) 938-0257
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G57007 CA Primary

Addresses

Primary practice location

1057 Grand Ave
Arroyo Grande, CA 93420-2504

Mailing address

170 Vista Cir
Arroyo Grande, CA 93420-1619
Phone (805) 720-2850

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 Medicine

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1053472373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 VISTA CIR",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201619",
            "telephone_number": "805-720-2850",
            "fax_number": "805-473-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 GRAND AVE",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202504",
            "telephone_number": "805-481-7220",
            "fax_number": "805-938-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERFLER",
        "first_name": "B.MELISSA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G57007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.