Individual provider Active NPI

Leighann Denise Dejesse

  • Student in an Organized Health Care Education/Training Program
  • San Francisco, CA
National Provider Identifier
1750578712
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
90 Alhambra St
Apt. 401
San Francisco, CA 94123-2116
Phone
(415) 971-9090
NPI assigned
Oct 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Clinical Psychologist 103TC0700X PSY26322 CA

Addresses

Primary practice location

90 Alhambra St
Apt. 401
San Francisco, CA 94123-2116

Mailing address

90 Alhambra St
Apt. 401
San Francisco, CA 94123-2116
Phone (415) 971-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160211002727 CA Practitioner - Clinical Psychologist 5890099899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Julia Evans PHD Psychology PCGroup PAC ID 0446510309, 17 clinicians

Practice addresses (Care Compare)

940 S Coast Dr
Suite 225
Costa Mesa, CA 92626-7757
Phone (949) 743-1457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY26322CAMDClinical Psychologist
26322CAMDReflexologist

Practice roles

OrganizationSpecialtyStatusNew patients
Julia Evans PHD Psychology PC Clinical CurrentSince Sep 18, 2021 Accepting new patients

Locations

2173 Salk Ave
Ste 250
Carlsbad, CA 92008
Phone (760) 477-8585

940 S Coast Dr
Ste 225
Costa Mesa, CA 92626
Phone (949) 742-1457

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1750578712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 ALHAMBRA ST",
            "address_2": "APT. 401",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941232116",
            "telephone_number": "415-971-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 ALHAMBRA ST",
            "address_2": "APT. 401",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941232116",
            "telephone_number": "415-971-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESSE",
        "first_name": "LEIGHANN",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.