NPIMap

Organization Active NPI

Tamar-Mattis, D.O., a Professional Organization

  • Family Medicine Physician
  • Sebastopol, CA
National Provider Identifier
1801605035
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TAMAR-MATTIS, D.O., A PROFESSIONAL ORGANIZATION
Practice address
1020 Gravenstein Hwy S Ste 120
Sebastopol, CA 95472-4863
Phone
(707) 861-0807
NPI assigned
Jan 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Authorized official

Name
Anne Tamar-Mattis
Title
Chief Adminsitrative Officer
Phone
(707) 861-0807

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

1020 Gravenstein Hwy S Ste 120
Sebastopol, CA 95472-4863

Mailing address

1020 Gravenstein Hwy S Ste 120
Sebastopol, CA 95472-4863
Phone (707) 861-0807

Other names 1

  • Liminal Medicine Doing business as

National Provider Directory

National Provider Directory

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": "1735776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1801605035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 GRAVENSTEIN HWY S STE 120",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724863",
            "telephone_number": "707-861-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 GRAVENSTEIN HWY S STE 120",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724863",
            "telephone_number": "707-861-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMAR-MATTIS, D.O., A PROFESSIONAL ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "TAMAR-MATTIS",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "CHIEF ADMINSITRATIVE OFFICER",
        "authorized_official_telephone_number": "707-861-0807"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liminal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.