Individual provider Active NPI

Sangitapriya Pedro, N.D.

  • Naturopath
  • Mill Valley, CA
National Provider Identifier
1043653074
Registry record updated Sep 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
ND1075 Issued in CA
Practice address
655 Redwood Hwy Frontage Rd
Mill Valley, CA 94941-3034
Phone
(415) 569-4470
Fax
(844) 787-4719
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 1426 OR
NaturopathGroup: 193400000X SINGLE SPECIALTY GROUP 175F00000X ND1075 CA Primary

Addresses

Primary practice location

655 Redwood Hwy Frontage Rd
Mill Valley, CA 94941-3034

Mailing address

3439 NE Sandy Blvd # 359
Portland, OR 97232-1959
Phone (207) 274-2111

Other practice location 1

1623 SE 6th Ave
Portland, OR 97214-3502
Phone (207) 274-4211

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

State licenses

LicenseStateTypeSpecialty
1426ORMDClinical Psychologist
ND1075CAMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726358400000",
    "number": "1043653074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3439 NE SANDY BLVD # 359",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321959",
            "telephone_number": "207-274-2111",
            "fax_number": "207-221-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 REDWOOD HWY FRONTAGE RD",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413034",
            "telephone_number": "415-569-4470",
            "fax_number": "844-787-4719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1623 SE 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972143502",
            "country_code": "US",
            "telephone_number": "207-274-4211",
            "fax_number": "207-221-1095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDRO",
        "first_name": "SANGITAPRIYA",
        "credential": "N.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1426",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Naturopath",
            "state": "CA",
            "license": "ND1075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2024; 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.