Active NPI
William Wade Deardorff, PH.D.
- Clinical Neuropsychologist
- Beverly Hills, CA
National Provider Identifier
1568413250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PSY9740
- Practice address
- 120 S Spalding Dr
Suite 400
Beverly Hills, CA 90212-1800 - Phone
- (714) 437-7400
- Fax
- (714) 437-7410
- NPI assigned
- May 15, 2006
- 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY9740 | CA | Primary |
Addresses
Primary practice location
120 S Spalding Dr
Suite 400
Beverly Hills, CA 90212-1800
Mailing address
PO Box 9061
Calabasas, CA 91372-9061
Phone (714) 437-7400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY9740 | Other | CA | STATE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY9740 | CA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394064000000",
"number": "1568413250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9061",
"city": "CALABASAS",
"state": "CA",
"postal_code": "913729061",
"telephone_number": "714-437-7400",
"fax_number": "714-437-7410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 S SPALDING DR",
"address_2": "SUITE 400",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902121800",
"telephone_number": "714-437-7400",
"fax_number": "714-437-7410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARDORFF",
"first_name": "WILLIAM",
"middle_name": "WADE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2014-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY9740",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "PSY9740",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.