Carole E. Deitrich

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

176113 Issued in CA

Practice address

3330 Geary Blvd
2 West, Institute on Aging Assessment Services
San Francisco, CA 94118-3347

Phone

(415) 750-4111

Fax

(415) 750-5341

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295827426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 SUSSEX ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941312935",
            "telephone_number": "415-476-1069",
            "fax_number": "415-476-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 GEARY BLVD",
            "address_2": "2 WEST, INSTITUTE ON AGING ASSESSMENT SERVICES",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941183347",
            "telephone_number": "415-750-4111",
            "fax_number": "415-750-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITRICH",
        "first_name": "CAROLE",
        "middle_name": "E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "176113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Deicke
• Raymond Friedrich Deicken, M.S., M.D.
• Jamie Deiner
• Jessica Deitch, PSYD
• Erik Paul Anton Deiters, LMFT
• Deizero, Inc.
• Victoria Alexis Dejaco, PHARMD
• Jessica Dejarnette, M.D.
• Leighann Denise Dejesse
• Danielle Dekker

• Gerontology Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.