Active NPI
Carlos Guerra Dreiss, PH.D.
- Psychologist
- Ione, CA
National Provider Identifier
1184773962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 19329
- Practice address
- 455 Eagle Dr
Ione, CA 95640-4504 - Phone
- (209) 207-8500
- NPI assigned
- Jan 9, 2007
- Last updated
- May 26, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 19329 | CA | Primary |
Addresses
Primary practice location
455 Eagle Dr
Ione, CA 95640-4504
Mailing address
455 Eagle Dr
Ione, CA 95640-4504
Phone (209) 207-8500
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 Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464220800000",
"number": "1184773962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 EAGLE DR",
"city": "IONE",
"state": "CA",
"postal_code": "956404504",
"telephone_number": "209-207-8500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 EAGLE DR",
"city": "IONE",
"state": "CA",
"postal_code": "956404504",
"telephone_number": "209-207-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DREISS",
"first_name": "CARLOS",
"middle_name": "GUERRA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2016-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "19329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.