Individual provider Active NPI

Dyan Alayne Dreisbach, M.D.

  • Prescribing (Medical) Psychologist
  • San Francisco, CA
National Provider Identifier
1396980520
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
A41399 Issued in CA
Practice address
1625 Carroll Ave
San Francisco, CA 94124-3219
Phone
(415) 822-8200
Fax
(415) 822-6822
NPI assigned
Dec 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) Psychologist 103TP0016X A41399 CA Primary

Addresses

Primary practice location

1625 Carroll Ave
San Francisco, CA 94124-3219

Mailing address

1625 Carroll Ave
San Francisco, CA 94124-3219
Phone (415) 822-8200

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A41399CAMDPrescribing (Medical) Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1396980520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 CARROLL AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941243219",
            "telephone_number": "415-822-8200",
            "fax_number": "415-822-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 CARROLL AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941243219",
            "telephone_number": "415-822-8200",
            "fax_number": "415-822-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREISBACH",
        "first_name": "DYAN",
        "middle_name": "ALAYNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "CA",
            "license": "A41399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in 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 2, 2008; 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.