Individual provider Active NPI

Tina Eileen Belisle, MSN

  • Ambulatory Care Registered Nurse
  • Santa Rosa, CA
National Provider Identifier
1437067295
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
95474429 Issued in CA
Practice address
3841 Brickway Blvd
Santa Rosa, CA 95403-8226
Phone
(707) 569-2300
NPI assigned
Aug 31, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 14018685-3102 UT
Ambulatory Care Registered Nurse 163WP2201X 95474429 CA Primary

Addresses

Primary practice location

3841 Brickway Blvd
Santa Rosa, CA 95403-8226

Mailing address

11820 River Rd SPC E4
Forestville, CA 95436-9826
Phone (707) 569-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1437067295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11820 RIVER RD SPC E4",
            "city": "FORESTVILLE",
            "state": "CA",
            "postal_code": "954369826",
            "telephone_number": "707-569-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 BRICKWAY BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038226",
            "telephone_number": "707-569-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELISLE",
        "first_name": "TINA",
        "middle_name": "EILEEN",
        "name_prefix": "Mrs.",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "UT",
            "license": "14018685-3102",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "CA",
            "license": "95474429",
            "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 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.