Active NPI
Rita Dora Mar Cordova
- Marriage & Family Therapist
- Santa Rosa, CA
National Provider Identifier
1538220801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF71843
- Practice address
- 3322 Chanate Rd
Santa Rosa, CA 95404-1708 - Phone
- (707) 565-4810
- Fax
- (707) 565-4907
- NPI assigned
- Dec 12, 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF71843 | CA | Primary |
Addresses
Primary practice location
3322 Chanate Rd
Santa Rosa, CA 95404-1708
Mailing address
3322 Chanate Rd
Santa Rosa, CA 95404-1708
Phone (707) 565-4810
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 |
|---|---|---|---|
| IMF71843 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426118400000",
"number": "1538220801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3322 CHANATE RD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954041708",
"telephone_number": "707-565-4810",
"fax_number": "707-565-4907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3322 CHANATE RD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954041708",
"telephone_number": "707-565-4810",
"fax_number": "707-565-4907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "RITA",
"middle_name": "DORA MAR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-12",
"last_updated": "2015-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF71843",
"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 Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.