NPIMap

Organization Active NPI

Rebecca Dodge, PH.D.

  • Community/Behavioral Health Agency
  • Sonora, CA
National Provider Identifier
1578860466
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
2520 Issued in CA
Legal business name
REBECCA DODGE, PH.D.
Practice address
145 S Washington St Ste H-2
Sonora, CA 95370-4722
Phone
(209) 532-5132
Fax
(209) 532-1348
NPI assigned
Feb 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Authorized official

Name
Dr. Rebecca Ann Dodge, PH.D.NPI 1033326699
Title
Owner
Phone
(209) 532-5132

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 2520 CA
Community/Behavioral Health Agency 251S00000X 2520 CA Primary

Addresses

Primary practice location

145 S Washington St Ste H-2
Sonora, CA 95370-4722

Mailing address

145 S Washington St Ste H-2
Sonora, CA 95370-4722
Phone (209) 532-5132

Other identifiers 1

IdentifierTypeStateIssuer
0513639MedicaidCA

Other names 1

  • Academic Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

145 S Washington St
Ste H2
Sonora, CA 95370
Phone (209) 532-5132

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315785600000",
    "number": "1578860466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S WASHINGTON ST STE H-2",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953704722",
            "telephone_number": "209-532-5132",
            "fax_number": "209-532-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S WASHINGTON ST STE H-2",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953704722",
            "telephone_number": "209-532-5132",
            "fax_number": "209-532-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA DODGE, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-11",
        "last_updated": "2011-09-12",
        "status": "A",
        "authorized_official_last_name": "DODGE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-532-5132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "CA",
            "license": "2520",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "2520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0513639",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Academic Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.