Tara Colleen Brunner

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

11202 Issued in CA

Practice address

4780 Londonberry Dr
Santa Rosa, CA 95403-1309

Phone

(707) 494-4266

NPI assigned

Feb 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1952803470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4780 LONDONBERRY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031309",
            "telephone_number": "707-494-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4780 LONDONBERRY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031309",
            "telephone_number": "707-494-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "TARA",
        "middle_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "11202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Brunn, NURSE PRACTITIONER
• Ryan Brunn
• Damien Michael Brunner, P.T.
• Leslie Brunner, OT
• Pamela Zane Brunner, PHD
• Amber Marie Bruno
• Darin Dee Brunson, MD
• Lindsay Marie Brunson, IBCLC
• Bruso Medical Group, Inc.
• Jessica Rose Bruso, DO

• Occupational Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.