Active NPI
John Deri, M.D.
- Psychiatry Physician
- Mill Valley, CA
National Provider Identifier
1598049652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G52083
- Practice address
- 10 Millwood Street
Suite #4
Mill Valley, CA 94941 - Phone
- (415) 388-8417
- NPI assigned
- Oct 6, 2011
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G52083 | CA | Primary |
Addresses
Primary practice location
10 Millwood Street
Suite #4
Mill Valley, CA 94941
Mailing address
10 Millwood Street
Suite #4
Mill Valley, CA 94941
Phone (415) 388-8417
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 Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317859200000",
"number": "1598049652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 MILLWOOD STREET",
"address_2": "SUITE #4",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "94941",
"telephone_number": "415-388-8417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 MILLWOOD STREET",
"address_2": "SUITE #4",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "94941",
"telephone_number": "415-388-8417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERI",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-06",
"last_updated": "2011-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G52083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mill Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.