Active NPI
Sutter Medical Group of the Redwoods
- Pediatrics Physician
- Santa Rosa, CA
National Provider Identifier
1407970544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- SUTTER MEDICAL GROUP OF THE REDWOODS
- Practice address
- 1200 Sonoma Ave
Suite 6
Santa Rosa, CA 95405-6664 - Phone
- (707) 545-2545
- Fax
- (707) 545-1829
- NPI assigned
- Mar 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Linda E Rockstroh
- Title
- Credentialing Specialist
- Phone
- (707) 521-8809
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | CA | Primary | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | CA | ||
| Nurse Practitioner | 363L00000X | CA |
Addresses
Primary practice location
1200 Sonoma Ave
Suite 6
Santa Rosa, CA 95405-6664
Mailing address
3883 Airway Dr
Santa Rosa
Santa Rosa, CA 95403-1670
Phone (707) 521-8809
National Provider Directory
National Provider DirectoryLocations
3883 Airway Dr
Santa Rosa, CA 95403
Phone (415) 751-1817
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1407970544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3883 AIRWAY DR",
"address_2": "SANTA ROSA",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954031670",
"telephone_number": "707-521-8809",
"fax_number": "707-521-8835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 SONOMA AVE",
"address_2": "SUITE 6",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954056664",
"telephone_number": "707-545-2545",
"fax_number": "707-545-1829"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUTTER MEDICAL GROUP OF THE REDWOODS",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-16",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "ROCKSTROH",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "707-521-8809"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "CA",
"license": null,
"primary": true
},
{
"code": "2080N0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "CA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
- Sutter Medical Group of the Redwoods
- Sutter Medical Group of the Redwoods
- Sutter Medical Group of the Redwoods
- Sutter Medical Group of the Redwoods
- Sutter Medical Group of the Redwoods
- Sutter Medical Group of the Redwoods
- Sutter Medical Group of the Redwoods
- Sutter Medical Group of the Redwoods
- Sutter Medical Group of the Redwoods
- Sutter Medical Group of the Redwoods
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.