Sonoma Memory Clinic

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

SONOMA MEMORY CLINIC

Practice address

401 S a St
Santa Rosa, CA 95401-8518

Phone

(707) 544-4441

NPI assigned

Aug 16, 2007

Organization subpart

No

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

Authorized official

Name

Michael Fraga, PSYD

Title

Director

Phone

(707) 544-4441

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1487846069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S A ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954018518",
            "telephone_number": "707-544-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S A ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954018518",
            "telephone_number": "707-544-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA MEMORY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "FRAGA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "707-544-4441",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonoma Eyeworks an Optometric Corporation
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• Sonoma Memory Center Comprehensive Psychology Services Professional Co
• Sonoma Surgical a Corp
• Sonoma Therapy Network
• Sonoma Therapy Network Support Services Inc
• Charles Daniel Sooy, MD
• Amanda Gibson Soper, MA OTR/L

• 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 Aug 16, 2007; 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.