Sonoma Diabetic Supplies

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

PHA462690 Issued in CA

Legal business name

SONOMA DIABETIC SUPPLIES

Practice address

246 Perkins St
Sonoma, CA 95476-6954

Phone

(707) 938-2667

Fax

(707) 938-5402

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sheila Rae Fanuccchi, RN

Title

Owner

Phone

(707) 938-2667

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760559447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 PERKINS ST",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766954",
            "telephone_number": "707-938-2667",
            "fax_number": "707-938-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 PERKINS ST",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766954",
            "telephone_number": "707-938-2667",
            "fax_number": "707-938-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA DIABETIC SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FANUCCCHI",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-938-2667",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "PHA462690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA462690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Smith
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• Michael A Sommer, MD
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• Sonoma Emergency Physicians Inc
• Sonoma Family Practice
• Sonoma Family Practice Medical Associates P C
• Sonoma Moon and Star Mental Health Inc
• Sonoma Naturopathic Medicine

• Durable Medical Equipment & Medical Supplies in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.