NPIMap

Organization Active NPI

Department of Health Services

  • Physical Therapy Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1376696914
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
DEPARTMENT OF HEALTH SERVICES
Practice address
2665A Dutton MDW
Santa Rosa, CA 95407-7730
Phone
(707) 565-4518
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Diana L Stornetta
Title
Accountant III Compliance
Phone
(707) 565-4782

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

2665A Dutton MDW
Santa Rosa, CA 95407-7730

Mailing address

2665A Dutton MDW
Santa Rosa, CA 95407-7730

National Provider Directory

National Provider Directory
Tax ID family
Community Hospital of61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2665A Dutton Mdw
Santa Rosa, CA 95407
Phone (707) 565-4518

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376696914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665A DUTTON MDW",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665A DUTTON MDW",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077730",
            "telephone_number": "707-565-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STORNETTA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ACCOUNTANT III COMPLIANCE",
        "authorized_official_telephone_number": "707-565-4782"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "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 Aug 22, 2020; 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.