Active NPI
Dianne Bohr, LMT
- Contractor
- Santa Rosa, CA
National Provider Identifier
1194897637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 10852
- Practice address
- 3452 Mendocino Ave # B
Santa Rosa, CA 95403-2221 - Phone
- (707) 206-8702
- NPI assigned
- Nov 13, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 10852 | OR | Primary |
Addresses
Primary practice location
3452 Mendocino Ave # B
Santa Rosa, CA 95403-2221
Mailing address
PO Box 1202
Santa Rosa, CA 95402-1202
Phone (707) 206-8702
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10852 | OR | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194897637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1202",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954021202",
"telephone_number": "707-206-8702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3452 MENDOCINO AVE # B",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954032221",
"telephone_number": "707-206-8702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHR",
"first_name": "DIANNE",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "OR",
"license": "10852",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.