Organization Active NPI

Desicouch

  • Community/Behavioral Health Agency
  • South San Francisco, CA
National Provider Identifier
1053633198
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
43971 Issued in CA
Legal business name
DESICOUCH
Practice address
61 Airport Blvd.
Ste. C
South San Francisco, CA 94080
Phone
(415) 267-4850
Fax
(415) 267-4850
NPI assigned
Feb 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Authorized official

Name
Miss Desdemonia Whittle, MFTNPI 1427221860
Title
President
Phone
(415) 267-4850

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 43971 CA Primary

Addresses

Primary practice location

61 Airport Blvd.
Ste. C
South San Francisco, CA 94080

Mailing address

61 Airport Blvd
Ste. C
South San Francisco, CA 94080-6522
Phone (415) 267-4850

National Provider Directory

National Provider Directory

Locations

61 Airport Blvd
Ste C
South San Francisco, CA 94080
Phone (415) 267-4850

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1053633198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 AIRPORT BLVD",
            "address_2": "STE. C",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940806522",
            "telephone_number": "415-267-4850",
            "fax_number": "415-267-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 AIRPORT BLVD.",
            "address_2": "STE. C",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94080",
            "telephone_number": "415-267-4850",
            "fax_number": "415-267-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESICOUCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "WHITTLE",
        "authorized_official_first_name": "DESDEMONIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-267-4850",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "43971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.