Individual provider Active NPI

William S Diles Jr.

  • Audiologist-Hearing Aid Fitter
  • Petaluma, CA
National Provider Identifier
1164560579
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AU973 Issued in CA
Practice address
1383 No. McDowell Blvd. #100
Petaluma, CA 94954
Phone
(707) 538-1000
Fax
(707) 538-1013
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X AU973 CA Primary

Addresses

Primary practice location

1383 No. McDowell Blvd. #100
Petaluma, CA 94954

Mailing address

1383 No. McDowell #100
Petaluma, CA 94954
Phone (707) 538-1000

Other identifiers 1

IdentifierTypeStateIssuer
HAD000150MedicaidCA

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

State licenses

LicenseStateTypeSpecialty
AU973CAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Hearing Solutions, Inc. Audiologist-Hearing Aid Fitter Current Accepting new patients

Locations

1383 N McDowell Blvd
Ste 100
Petaluma, CA 94954
Phone (707) 763-6400

593 N McDowell Blvd
Ste C
Petaluma, CA 94954
Phone (707) 778-6503

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1164560579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1383 NO. MCDOWELL #100",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-538-1000",
            "fax_number": "707-538-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1383 NO. MCDOWELL BLVD. #100",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-538-1000",
            "fax_number": "707-538-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILES",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAD000150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.