Active NPI
Kathleen Elaine Fields
- Physical Therapy Assistant
- Petaluma, CA
National Provider Identifier
1497789374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 8737
- Practice address
- 300 Douglas St
Petaluma, CA 94952-2503 - Phone
- (707) 763-6887
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8737 | CA | Primary |
Addresses
Primary practice location
300 Douglas St
Petaluma, CA 94952-2503
Mailing address
696 Draco Dr
Petaluma, CA 94954-6605
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8737 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625616000000",
"number": "1497789374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "696 DRACO DR",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949546605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 DOUGLAS ST",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949522503",
"telephone_number": "707-763-6887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIELDS",
"first_name": "KATHLEEN",
"middle_name": "ELAINE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2021-07-07",
"certification_date": "2021-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "8737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.