Active NPI
Jesse G Defrese, DC
- Chiropractor
- Davis, CA
National Provider Identifier
1578652913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC18378
- Practice address
- 423 F Street
Suite 109
Davis, CA 95616 - Phone
- (530) 758-8654
- Fax
- (530) 758-8654
- NPI assigned
- Oct 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC18378 | CA | Primary |
Addresses
Primary practice location
423 F Street
Suite 109
Davis, CA 95616
Mailing address
PO Box 4659
Davis, CA 95617
Phone (530) 758-8654
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC18378 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578652913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4659",
"city": "DAVIS",
"state": "CA",
"postal_code": "95617",
"telephone_number": "530-758-8654",
"fax_number": "530-758-8654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "423 F STREET",
"address_2": "SUITE 109",
"city": "DAVIS",
"state": "CA",
"postal_code": "95616",
"telephone_number": "530-758-8654",
"fax_number": "530-758-8654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFRESE",
"first_name": "JESSE",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC18378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davis, 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.