Individual provider Active NPI

Julia Vander Vennet

  • Psychologist
  • Santa Rosa, CA
National Provider Identifier
1134032782
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3482 Issued in CA
Practice address
5247 Beaumont Way
Santa Rosa, CA 95409-2811
Phone
(415) 250-7774
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3482 CA Primary

Addresses

Primary practice location

5247 Beaumont Way
Santa Rosa, CA 95409-2811

Mailing address

5247 Beaumont Way
Santa Rosa, CA 95409-2811
Phone (415) 250-7774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1134032782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5247 BEAUMONT WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092811",
            "telephone_number": "415-250-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5247 BEAUMONT WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092811",
            "telephone_number": "415-250-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER VENNET",
        "first_name": "JULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "3482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.