Deborah Doherty, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

G43130 Issued in CA

Practice address

1125 Sir Francis Drake Blvd
Kentfield, CA 94904-1418

Phone

(415) 485-3524

Fax

(415) 485-3507

NPI assigned

Aug 5, 2006

Last updated

Sep 3, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1689683112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 SIR FRANCIS DRAKE BLVD",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041418",
            "telephone_number": "415-485-3524",
            "fax_number": "415-485-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SIR FRANCIS DRAKE BLVD",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041418",
            "telephone_number": "415-485-3524",
            "fax_number": "415-485-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "DEBORAH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G43130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G431300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Deltredici, M.S., R.D.
• Lauren Derby, DPT
• Joan Leslie Difuria, MFT
• Ilene L. Dillon, M.S.W.
• Boyka Dimitrova
• Angela Claire Dotson, LMFT 112318
• Stacey Nicole Drew, OTD, OTR/L
• Joan Driscoll, PH.D.
• Lael Conway Duncan, MD
• Roberta C Duncan, MFT

• Physical Medicine & Rehabilitation Physician in Kentfield, CA
• Providers in Kentfield, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.