Active NPI
Eliza Zetino
- Dental Assistant
- Petaluma, CA
National Provider Identifier
1164069480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- 599 Tomales Rd
Petaluma, CA 94952-5002 - Phone
- (707) 765-7200
- NPI assigned
- Dec 5, 2019
- Last updated
- Dec 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
599 Tomales Rd
Petaluma, CA 94952-5002
Mailing address
2056 Easton Dr
Petaluma, CA 94952-5261
Phone (661) 289-0030
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575504000000",
"number": "1164069480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2056 EASTON DR",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949525261",
"telephone_number": "661-289-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "599 TOMALES RD",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949525002",
"telephone_number": "707-765-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZETINO",
"first_name": "ELIZA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-05",
"last_updated": "2019-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.