Individual provider Active NPI

Deshay Tywin Peterson

  • Rehabilitation Practitioner
  • Bakersfield, CA
National Provider Identifier
1821726746
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
10918 Villa Hermosa Dr
Bakersfield, CA 93311-9373
Phone
(661) 654-8559
NPI assigned
Aug 9, 2022
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Case Manager/Care Coordinator 171M00000X CA
Rehabilitation Practitioner 225400000X CA Primary

Addresses

Primary practice location

10918 Villa Hermosa Dr
Bakersfield, CA 93311-9373

Mailing address

7849 Oceanus Dr
Los Angeles, CA 90046-2042
Phone (310) 909-3817

Other practice location 1

5417 Pacer Valley Ct
Bakersfield, CA 93313-4304
Phone (661) 654-8559

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL BestNotes Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Horizon Group Homes, Inc. CurrentSince Sep 20, 2022 Accepting new patients
Matthew Wong MD, Inc PastSince Sep 20, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1821726746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7849 OCEANUS DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900462042",
            "telephone_number": "310-909-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10918 VILLA HERMOSA DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119373",
            "telephone_number": "661-654-8559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5417 Pacer Valley Ct",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933134304",
            "country_code": "US",
            "telephone_number": "661-654-8559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DESHAY",
        "middle_name": "TYWIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "BestNotes",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5417 Pacer Valley Ct",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933134304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.