NPIMap

Organization Active NPI

Redwood Psychalliance

  • Psychiatry Physician
  • Santa Rosa, CA
National Provider Identifier
1730440223
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G24040 Issued in CA
Legal business name
REDWOOD PSYCHALLIANCE
Practice address
509 7TH St Ste 100
Santa Rosa, CA 95401-5297
Phone
(707) 568-1101
Fax
(707) 568-1103
NPI assigned
May 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Authorized official

Name
Dr. Lorette Marie Labataille, MDNPI 1376728022
Title
Owner/President
Phone
(707) 568-1101

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X MFC25326 CA
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X G24040 CA Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X A33863 CA

Addresses

Primary practice location

509 7TH St Ste 100
Santa Rosa, CA 95401-5297

Mailing address

509 7TH St Ste 100
Santa Rosa, CA 95401-5297
Phone (707) 568-1101

National Provider Directory

National Provider Directory

Locations

509 7th St
Ste 100
Santa Rosa, CA 95401
Phone (707) 568-1101

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": "1338422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1730440223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 7TH ST STE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015297",
            "telephone_number": "707-568-1101",
            "fax_number": "707-568-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 7TH ST STE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015297",
            "telephone_number": "707-568-1101",
            "fax_number": "707-568-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD PSYCHALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-31",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "LABATAILLE",
        "authorized_official_first_name": "LORETTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "707-568-1101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC25326",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G24040",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A33863",
            "primary": false
        }
    ],
    "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 Jan 8, 2018; 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.