Embodied Wisdom Osteopathy PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EMBODIED WISDOM OSTEOPATHY PC

Practice address

7064 Corline CT Ste C1
Sebastopol, CA 95472-4528

Phone

(707) 339-8018

NPI assigned

Aug 8, 2024

Last updated

Aug 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Victoria Lorraine P Williams, DO

Title

Owner

Phone

(707) 339-8018

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Victoria Lorraine Williams, DO

  • Family Medicine Physician
  • Petaluma, CA
  • NPI 1659705564
  Medicare reassignment NPD

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1578394888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 MERCED AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076514",
            "telephone_number": "707-339-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7064 CORLINE CT STE C1",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724528",
            "telephone_number": "707-339-8018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Pleasant Hill Ave N Ste 340A",
            "address_purpose": "LOCATION",
            "city": "Sebastopol",
            "state": "CA",
            "postal_code": "954723168",
            "country_code": "US",
            "telephone_number": "707-339-8018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMBODIED WISDOM OSTEOPATHY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "P WILLIAMS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-339-8018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyla Wolff Ehrenreich, PA-C
• Amanda Elderkin, CPM, LM
• Gerald Eugene Eliaser, M.D.
• Isaac Gabriel Eliaz, MD
• Mellisa Nicole Elrod, OTR/L
• Empowered Educational Psychology Services
• Robert Karl Engel, CALIFORNIA MFT
• Ilene English, MFT
• James F. Yusuf Q. Erskine, D.O.
• Vipassana Christine Esbjorn

• Clinic/Center in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.