Active NPI
Kathy Matonak, AU.D.
- Audiologist
- Santa Rosa, CA
National Provider Identifier
1548310188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AU803
- Practice address
- 3333 Mendocino Ave
Suite 240
Santa Rosa, CA 95403-2261 - Phone
- (707) 566-5201
- Fax
- (707) 566-5203
- NPI assigned
- Jan 12, 2007
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | AU803 | CA | Primary |
Addresses
Primary practice location
3333 Mendocino Ave
Suite 240
Santa Rosa, CA 95403-2261
Mailing address
3333 Mendocino Ave Ste 240
Santa Rosa, CA 95403-3631
Phone (707) 566-5201
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 |
|---|---|---|---|
| AU803 | CA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548310188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 MENDOCINO AVE STE 240",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954033631",
"telephone_number": "707-566-5201",
"fax_number": "707-566-5203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 MENDOCINO AVE",
"address_2": "SUITE 240",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954032261",
"telephone_number": "707-566-5201",
"fax_number": "707-566-5203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATONAK",
"first_name": "KATHY",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "CA",
"license": "AU803",
"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 Jul 8, 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.