Tatra-Li De la Rosa

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

83945 Issued in CA

Practice address

576 B St Ste 2C
Santa Rosa, CA 95401-5269

Phone

(707) 536-5069

NPI assigned

Sep 10, 2015

Sex

Female

Sole proprietor

Yes

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

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• De la Rosa Psychotherapists, a MFT Corporation

  • Marriage & Family Therapist
  • Santa Rosa, CA
  • NPI 1861224263
  NPD Authorized official

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731110400000",
    "number": "1366810194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 B ST STE 2C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015269",
            "telephone_number": "707-536-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 B ST STE 2C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015269",
            "telephone_number": "707-536-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA ROSA",
        "first_name": "TATRA-LI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "83945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Briana De Angelo
• Ilka Louise De Gast, PSYD
• Carla De la Chapelle
• Rudolpho Eduardo De la O, RAS
• De la Rosa Psychotherapists, a MFT Corporation
• Jennifer De Los Santos
• Jake Lee De Souza
• Brenda Rena Deadwyler
• Breanna Dean
• Donald Wayne Dean Jr.

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.