NPIMap

Organization Active NPI

Dehesa Dermatology Inc

  • Dermatology Physician
  • Clovis, CA
National Provider Identifier
1194518977
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DEHESA DERMATOLOGY INC
Practice address
978 N Temperance Ave
Clovis, CA 93611-8606
Phone
(559) 951-9000
Fax
(559) 234-6334
NPI assigned
May 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Luis Alberto Dehesa, MDNPI 1629412259
Title
Dermatologist
Phone
(559) 951-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

978 N Temperance Ave
Clovis, CA 93611-8606

Mailing address

978 N Temperance Ave
Clovis, CA 93611-8606
Phone (559) 951-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260218004228 CA Part B Supplier - Clinic/Group Practice 6002396900 Receives reassigned benefits from 5 practitioners
Practice locations: Clovis, CA

National Provider Directory

National Provider Directory
Tax ID family
Dehesa Dermatology Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1194518977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "978 N TEMPERANCE AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936118606",
            "telephone_number": "559-951-9000",
            "fax_number": "559-234-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "978 N TEMPERANCE AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936118606",
            "telephone_number": "559-951-9000",
            "fax_number": "559-234-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEHESA DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-26",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "DEHESA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "559-951-9000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.