Individual provider Active NPI

Dean C. Delis, PH.D.

  • Clinical Neuropsychologist
  • San Diego, CA
National Provider Identifier
1508889445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY 6971 Issued in CA
Practice address
V a Medical Ctr # 116B
3350 La Jolla Village Drive
San Diego, CA 92161-0001
Phone
(619) 921-1900
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY 6971 CA Primary

Addresses

Primary practice location

V a Medical Ctr # 116B
3350 La Jolla Village Drive
San Diego, CA 92161-0001

Mailing address

V a Medical Ctr # 116B
3350 La Jolla Village Drive
San Diego, CA 92161-0001
Phone (619) 921-1900

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

State licenses

LicenseStateTypeSpecialty
PSY 6971CAMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508889445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "V A MEDICAL CTR # 116B",
            "address_2": "3350 LA JOLLA VILLAGE DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610001",
            "telephone_number": "619-921-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "V A MEDICAL CTR # 116B",
            "address_2": "3350 LA JOLLA VILLAGE DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610001",
            "telephone_number": "619-921-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELIS",
        "first_name": "DEAN",
        "middle_name": "C.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 6971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • 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.