Tara Lynn Dikeman, M.ED.,OTR

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

5905 Issued in CA

Practice address

2665 A Dutton Meadow Ave
Santa Rosa, CA 95407-7730

Phone

(707) 565-8185

Fax

(707) 565-8190

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1427110741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 A DUTTON MEADOW AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077730",
            "telephone_number": "707-565-8185",
            "fax_number": "707-565-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 A DUTTON MEADOW AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077730",
            "telephone_number": "707-565-8185",
            "fax_number": "707-565-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIKEMAN",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "M.ED.,OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "5765",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "5905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301830",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Dickison, AMFT
• Sheila Blythe Dickson, PH.D.
• Robert P Didier, D.D.S.
• Heidi Diebel, LMFT
• Caitlyn Diebold
• Vanla Nyna Dikousman
• Christine G Diles
• William Samuel Diles III
• Ralph Edward Dilisio, M.D., F.C.C.P.
• Sheri Rochelle Dillon, PSY.D.

• Pediatric Occupational Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.