DR. DESDEMONA WHITLEY DC
NPI 1598533911
Chiropractor in San Diego, CA

Q: What is Desdemona Whitley's NPI number?

The NPI number for Desdemona Whitley is 1598533911. It was assigned to this individual provider in the NPPES registry on December 14, 2023.

Q: What is Desdemona Whitley's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Q: When was this NPI record last updated?

The NPPES record for Desdemona Whitley was last updated on December 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 14, 2023Accepts Medicare Assignment

4060 FAIRMONT AVE., SAN DIEGO, CA 92105(619) 889-8834 Get Directions Write a Review

NPPES record last updated: December 14, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Desdemona Whitley Dc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DESDEMONA WHITLEY DC (NPI 1598533911) is an individual chiropractor in San Diego, California, licensed in California (28762) and active in the NPI registry since December 2023. She is a graduate of Palmer College Chiropractic - West Sunnyvale (2002).

NPPES Registry Identity

NPI1598533911

Entity TypeIndividualFemale

Primary Taxonomy111N00000X

Provider Legal NameDR. DESDEMONA WHITLEYCredential: DC

Location Address4060 FAIRMONT AVE.San Diego, CA 92105

Mailing Address1304 San Bernardino AveSpring Valley, CA 91977-4632 · (619) 889-8834

Phone(619) 889-8834

Sole ProprietorNo

Medical School CMSPalmer College Chiropractic - West SunnyvaleGraduated 2002

Enumeration DateDecember 14, 2023

NPPES CertifiedDecember 13, 2023

✔ NPI 1598533911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in CA · 28762

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

4060 FAIRMONT AVE., San Diego, CA 92105

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Desdemona Whitley Dc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466345574

PECOS Enrollment IDI20040203000985

Medicare Billing Reassignment

Medicare enrollment records show Desdemona Whitley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

La Maestra Family Clinic, Inc.

Same address

Federally Qualified Health Center (FQHC)

4060 FAIRMOUNT AVE
San Diego, CA 92105

Reassigned Medicare billing, California enrollment
102 clinicians in this Medicare group

NPI 1609849074 (619) 280-4213

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Desdemona Whitley's NPI number?

The NPI number for Desdemona Whitley is 1598533911. It was assigned to this individual provider in the NPPES registry on December 14, 2023.

Where is Desdemona Whitley located?

Desdemona Whitley practices at 4060 Fairmont Ave., San Diego, CA 92105. The listed phone number is (619) 889-8834.

What is Desdemona Whitley's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Desdemona Whitley enrolled in Medicare?

Yes. Desdemona Whitley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Desdemona Whitley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Desdemona Whitley reassigns Medicare benefits to La Maestra Family Clinic, Inc. (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Desdemona Whitley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Desdemona Whitley accept?

Health plans from Providence Health Plan list Desdemona Whitley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Desdemona Whitley was last updated on December 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.