Sonoma Memory Center Comprehensive Psychology Services Professional Co

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY13957 Issued in CA

Legal business name

SONOMA MEMORY CENTER COMPREHENSIVE PSYCHOLOGY SERVICES PROFESSIONAL CO

Practice address

1111 Sonoma Ave
Ste 322
Santa Rosa, CA 95405-4819

Phone

(707) 546-3300

Fax

(415) 457-3819

NPI assigned

Jul 29, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Edgar O Angelone, PHD

Title

President

Phone

(707) 546-3300

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Eric Joseph Freitag, PHD

  • Psychologist
  • Walnut Creek, CA
  • NPI 1437291168
  NPD (past)

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1427362680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVE",
            "address_2": "STE 322",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054819",
            "telephone_number": "707-546-3300",
            "fax_number": "415-457-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVE",
            "address_2": "STE 322",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054819",
            "telephone_number": "707-546-3300",
            "fax_number": "415-457-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA MEMORY CENTER COMPREHENSIVE PSYCHOLOGY SERVICES PROFESSIONAL CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-29",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "ANGELONE",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-546-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY13957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonoma Critical Care Associates Inc
• Sonoma Eyeworks an Optometric Corporation
• Sonoma Family Therapy Inc
• Sonoma Health Institute PC
• Sonoma in-Home Aides, LLC
• Sonoma Memory Clinic
• Sonoma Surgical a Corp
• Sonoma Therapy Network
• Sonoma Therapy Network Support Services Inc
• Charles Daniel Sooy, MD

• Clinical Neuropsychologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.