Anthony Santiago Cordova Martinez, MA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

790 Sonoma Ave
Santa Rosa, CA 95404-4713

Phone

(707) 360-4368

NPI assigned

Jan 9, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Drug Abuse Alternatives Center

  • Substance Abuse Rehabilitation Facility
  • Santa Rosa, CA
  • NPI 1568218469
  NPD
• Drug Abuse Alternatives Center

  • Addiction (Substance Use Disorder) Counselor
  • Santa Rosa, CA
  • NPI 1063064715
  NPD (past)

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1114737327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 PROFESSIONAL DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033007",
            "telephone_number": "707-360-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 SONOMA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044713",
            "telephone_number": "707-360-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA MARTINEZ",
        "first_name": "ANTHONY",
        "middle_name": "SANTIAGO",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Teresa Cooper, DO
• Thomas John Cooper
• Anna Renee Coopersmith, OTR/L, CHT
• Michael Corbett
• Nichole Alissa Cordoba
• Rita Dora Mar Cordova
• Robin Cordova
• Jennie Corella-Nestor
• Kristina Corley
• Christopher Cormier

• Medical Physician Assistant in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.