Robert John Stadelhofer, CAS

Primary specialty

SpecialistTaxonomy code 174400000X

License

03-056467 Issued in CA

Practice address

5494 Pony Express Trail
Pollock Pines, CA 95726

Phone

(530) 644-3758

NPI assigned

Mar 16, 2007

Last updated

Jul 29, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progress House Inc.

  • Substance Abuse Rehabilitation Facility
  • Pollock Pines, CA
  • NPI 1417112228
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1699899708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1721",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956671721",
            "telephone_number": "530-306-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5494 PONY EXPRESS TRAIL",
            "city": "POLLOCK PINES",
            "state": "CA",
            "postal_code": "95726",
            "telephone_number": "530-644-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADELHOFER",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "03-056467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Salvino, RADT I
• La Tisha Lynn San Pedro-Lintag, LMFT 133780
• Shining Star Children's Therapy, Inc
• Sierra Pines Speech Therapy & Myofunctional Services
• Jessica Spangler, LMFT
• Marbel D Steves, IBCLC
• Maryam Syed
• Brooke E Talent
• Joseph Cree Taylor, MD
• Hayden Bryce Threadgill

• Specialist in Pollock Pines, CA
• Providers in Pollock Pines, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; 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.