Active NPI
Andrea Mazzola
- Naturopath
- Santa Rosa, CA
National Provider Identifier
1922624113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- ND1161
- Practice address
- 175 Concourse Blvd
Santa Rosa, CA 95403-8217 - Phone
- (707) 284-9200
- NPI assigned
- Jun 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | ND1161 | CA | Primary |
Addresses
Primary practice location
175 Concourse Blvd
Santa Rosa, CA 95403-8217
Mailing address
3632 Idaho Dr
Santa Rosa, CA 95405-7322
Phone (415) 254-3304
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND1161 | CA | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1922624113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3632 IDAHO DR",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954057322",
"telephone_number": "415-254-3304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 CONCOURSE BLVD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954038217",
"telephone_number": "707-284-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZZOLA",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-23",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "CA",
"license": "ND1161",
"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 Jun 23, 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.