Individual provider Active NPI

Derron Pocci

  • Counselor
  • San Francisco, CA
National Provider Identifier
1679988174
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1801 Vicente St
San Francisco, CA 94116-2923
Phone
(415) 418-9704
NPI assigned
Jun 24, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

1801 Vicente St
San Francisco, CA 94116-2923

Mailing address

1801 Vicente St
San Francisco, CA 94116-2923
Phone (415) 418-9704

Other identifiers 2

IdentifierTypeStateIssuer
172V00000XOtherCA172V00000X
172V00000XMedicaidCA

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

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1679988174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162923",
            "telephone_number": "415-418-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162923",
            "telephone_number": "415-418-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCCI",
        "first_name": "DERRON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "172V00000X",
            "identifier": "172V00000X",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172V00000X",
            "state": "CA"
        }
    ],
    "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 Jun 24, 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.

Verify at the official NPI Registry.