Individual provider Active NPI

Paul Tepper, RN

  • Psychiatric/Mental Health Registered Nurse
  • Santa Rosa, CA
National Provider Identifier
1861942484
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
95053437 Issued in CA
Practice address
3333 Chanate Rd
Santa Rosa, CA 95404-1707
Phone
(707) 481-8638
NPI assigned
Oct 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95053437 CA Primary

Addresses

Primary practice location

3333 Chanate Rd
Santa Rosa, CA 95404-1707

Mailing address

3418 Woolsey Rd
Windsor, CA 95492-9649
Phone (707) 481-8638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95053437CAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1861942484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 WOOLSEY RD",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954929649",
            "telephone_number": "707-481-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041707",
            "telephone_number": "707-481-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEPPER",
        "first_name": "PAUL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95053437",
            "primary": true
        }
    ],
    "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 Oct 6, 2016; 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.