| Traditions Behavioral Health | |
|
1287 Fulton Rd Santa Rosa CA 95401-4923 | |
| (707) 258-8757 | |
| (707) 253-0457 |
| Full Name | Traditions Behavioral Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1287 Fulton Rd, Santa Rosa, California |
| Authorized Official Name and Position | Julianne Bharucha (CFO) |
| Authorized Official Contact | 7757623679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Traditions Behavioral Health 900 Larkspur Landing Cir Ste 160 Larkspur CA 94939-1766 Ph: (707) 258-8757 | Traditions Behavioral Health 1287 Fulton Rd Santa Rosa CA 95401-4923 Ph: (707) 258-8757 |
| NPI Number | 1083802979 |
|---|---|
| Provider Enumeration Date | 10/04/2007 |
| Last Update Date | 08/15/2023 |
| Certification Date | 08/15/2023 |
| Medicare PECOS PAC ID | 8729984539 |
|---|---|
| Medicare Enrollment ID | O20031211000677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083802979 | NPI | - | NPPES |
| GPS001190 | Medicaid | CA | |
| CA298849 | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Larry Charles Lawrence |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528167061 PECOS PAC ID: 8224923255 Enrollment ID: I20040218000926 |
| Provider Name | Rick L Jenkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275502825 PECOS PAC ID: 8022093376 Enrollment ID: I20040621001431 |
| Provider Name | Jonathan A Kistler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033161740 PECOS PAC ID: 7214980424 Enrollment ID: I20050228001070 |
| Provider Name | Ronnie R Cummings |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255537940 PECOS PAC ID: 1355363938 Enrollment ID: I20051222000722 |
| Provider Name | Mounir Belcadi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053341073 PECOS PAC ID: 9032122486 Enrollment ID: I20060801000318 |
| Provider Name | Albert U Ma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275596496 PECOS PAC ID: 1254332364 Enrollment ID: I20070116000259 |
| Provider Name | Barrett G Levine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114087533 PECOS PAC ID: 2860595634 Enrollment ID: I20070315000276 |
| Provider Name | Sridhar Prathikanti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306920640 PECOS PAC ID: 1658474721 Enrollment ID: I20070920000869 |
| Provider Name | Vanessa Vianey Hernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891836425 PECOS PAC ID: 8921160656 Enrollment ID: I20081215000301 |
| Provider Name | Bruce N Anderson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942276324 PECOS PAC ID: 1254230238 Enrollment ID: I20081224000071 |
| Provider Name | Eric J Khoury |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972555274 PECOS PAC ID: 3375681885 Enrollment ID: I20091103000412 |
| Provider Name | Michael H Feddersen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871710160 PECOS PAC ID: 2264571728 Enrollment ID: I20091123000699 |
| Provider Name | Shailesh Gandhi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326218686 PECOS PAC ID: 5597733147 Enrollment ID: I20091130000268 |
| Provider Name | Christopher M Sue |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639225444 PECOS PAC ID: 0042353583 Enrollment ID: I20100204000906 |
| Provider Name | Charles D Barton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881688505 PECOS PAC ID: 0143229039 Enrollment ID: I20100506000997 |
| Provider Name | Scott Nichols |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295989572 PECOS PAC ID: 8325176316 Enrollment ID: I20100512000827 |
| Provider Name | Pei-huey Nie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235317256 PECOS PAC ID: 5890980742 Enrollment ID: I20101117000738 |
| Provider Name | Gail D Ingram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902928302 PECOS PAC ID: 7012932346 Enrollment ID: I20110310000482 |
| Provider Name | Robert L Oldham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356379507 PECOS PAC ID: 3678759735 Enrollment ID: I20110525000622 |
| Provider Name | Danielle A Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144531450 PECOS PAC ID: 3375705197 Enrollment ID: I20120424000234 |
| Provider Name | Brigitte Apfel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073780714 PECOS PAC ID: 3779745716 Enrollment ID: I20120508000680 |
| Provider Name | Ashraf Ismail |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720211691 PECOS PAC ID: 2264696749 Enrollment ID: I20120613000324 |
| Provider Name | Dora-linda L Wang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831110071 PECOS PAC ID: 7517059751 Enrollment ID: I20120913000658 |
| Provider Name | Devin M Stroman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811247810 PECOS PAC ID: 0547406415 Enrollment ID: I20130419000106 |
| Provider Name | Meena Rajendren |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790927572 PECOS PAC ID: 8820235195 Enrollment ID: I20130503000271 |
| Provider Name | Megha Miglani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861792491 PECOS PAC ID: 9739328527 Enrollment ID: I20130627000436 |
| Provider Name | Katherine Rose Hulbert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225270903 PECOS PAC ID: 0244470102 Enrollment ID: I20130717000631 |
| Provider Name | Yuliya M Perch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043475569 PECOS PAC ID: 3173719150 Enrollment ID: I20130820001041 |
| Provider Name | Duane Emil Mcwaine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629112123 PECOS PAC ID: 2163646712 Enrollment ID: I20140621000005 |
| Provider Name | Russell Ronald Monroe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932237450 PECOS PAC ID: 8820314396 Enrollment ID: I20150226002072 |
| Provider Name | Suzanna L Freerksen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881821791 PECOS PAC ID: 6901069848 Enrollment ID: I20150414002219 |
| Provider Name | Asher Raphael Gorelik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902910649 PECOS PAC ID: 2567528318 Enrollment ID: I20150602000434 |
| Provider Name | Qyana K Griffith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255674495 PECOS PAC ID: 4183935984 Enrollment ID: I20150619002305 |
| Provider Name | Dustin G Sanchez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396063129 PECOS PAC ID: 6709190564 Enrollment ID: I20150806012320 |
| Provider Name | Mukesh K Sanghadia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366550246 PECOS PAC ID: 6800803883 Enrollment ID: I20150901001397 |
| Provider Name | Safi Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114363876 PECOS PAC ID: 4183933666 Enrollment ID: I20151023000735 |
| Provider Name | Agnieszka Kalinowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679917678 PECOS PAC ID: 4284944596 Enrollment ID: I20151116002696 |
| Provider Name | Jonathan B Terry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841424728 PECOS PAC ID: 7416189071 Enrollment ID: I20151117000327 |
| Provider Name | Nancy B Herron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780621367 PECOS PAC ID: 9032023387 Enrollment ID: I20160328000514 |
| Provider Name | Siddarth Puri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568718401 PECOS PAC ID: 3971801523 Enrollment ID: I20160414000738 |
| Provider Name | Amy Christina Woods |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699193623 PECOS PAC ID: 5496053605 Enrollment ID: I20160420002040 |
| Provider Name | Reza Tadayon Nejad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326329012 PECOS PAC ID: 6800010992 Enrollment ID: I20160630002254 |
| Provider Name | Brinda S Krishnan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114970076 PECOS PAC ID: 1759369549 Enrollment ID: I20160808002158 |
| Provider Name | Joshua Mark Flatow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487996302 PECOS PAC ID: 9335434430 Enrollment ID: I20160829002196 |
| Provider Name | Larry Ozowara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295046407 PECOS PAC ID: 5092038927 Enrollment ID: I20160906002285 |
| Provider Name | Karen Lai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710304910 PECOS PAC ID: 5395024780 Enrollment ID: I20161107001794 |
| Provider Name | Yehonatan Borenstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386063089 PECOS PAC ID: 2769762178 Enrollment ID: I20161130002381 |
| Provider Name | Earl Andrew Balayan De Guzman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821432378 PECOS PAC ID: 8628358801 Enrollment ID: I20161205001169 |
| Provider Name | Heather Lewerenz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891902698 PECOS PAC ID: 9335439082 Enrollment ID: I20170215001558 |
| Provider Name | Kamaldeep S Sandhu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629483219 PECOS PAC ID: 2466731120 Enrollment ID: I20170222002126 |
| Provider Name | Benjamin R Berry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033536073 PECOS PAC ID: 5496028029 Enrollment ID: I20170901002847 |
| Provider Name | Adham Nabil Malaty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174818587 PECOS PAC ID: 6002039351 Enrollment ID: I20171012001046 |
| Provider Name | Frank Massey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699821207 PECOS PAC ID: 1557496148 Enrollment ID: I20171116001882 |
| Provider Name | Alejandro Perez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275951832 PECOS PAC ID: 9537426846 Enrollment ID: I20171121002754 |
| Provider Name | Stefana B Morgan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649698101 PECOS PAC ID: 5395024467 Enrollment ID: I20171218002071 |
| Provider Name | Alberto G Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497955637 PECOS PAC ID: 3375803638 Enrollment ID: I20180205002849 |
| Provider Name | Katherine Cole |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447469192 PECOS PAC ID: 1850487406 Enrollment ID: I20180208002959 |
| Provider Name | Douglas Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336280023 PECOS PAC ID: 7416109012 Enrollment ID: I20180521000997 |
| Provider Name | Jill K Norman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366817983 PECOS PAC ID: 0042575763 Enrollment ID: I20180530002659 |
| Provider Name | Vikram Malhotra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033407986 PECOS PAC ID: 1254588148 Enrollment ID: I20180530003220 |
| Provider Name | Sateesh K Gunda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134407844 PECOS PAC ID: 2466764881 Enrollment ID: I20180611001811 |
| Provider Name | Brian T Anderson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184042699 PECOS PAC ID: 0840588968 Enrollment ID: I20180615001979 |
| Provider Name | Beverly Ann Reader |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396937868 PECOS PAC ID: 6406913631 Enrollment ID: I20180619002900 |
| Provider Name | Brian Keith Sparks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780940403 PECOS PAC ID: 6305193434 Enrollment ID: I20180720001563 |
| Provider Name | Sarbani Maitra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134360647 PECOS PAC ID: 0244597318 Enrollment ID: I20180720002947 |
| Provider Name | Chase R Warren |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992140040 PECOS PAC ID: 0648528851 Enrollment ID: I20180803002547 |
| Provider Name | Jacob A Leivent |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326452756 PECOS PAC ID: 1557629284 Enrollment ID: I20180817002244 |
| Provider Name | Nina Vasan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952749418 PECOS PAC ID: 7113277245 Enrollment ID: I20180911000773 |
| Provider Name | Alexander Thanh Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821330069 PECOS PAC ID: 0042560906 Enrollment ID: I20180913003078 |
| Provider Name | Neha P Chaudhary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720346315 PECOS PAC ID: 1850685280 Enrollment ID: I20180928002702 |
| Provider Name | Chris Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710306345 PECOS PAC ID: 8820342900 Enrollment ID: I20181107003013 |
| Provider Name | Dana M Arlien |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760506927 PECOS PAC ID: 0446309181 Enrollment ID: I20181108000799 |
| Provider Name | Megan P Della Selva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306145016 PECOS PAC ID: 7416256441 Enrollment ID: I20181113003301 |
| Provider Name | Katherine Rachel Roberts |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740607019 PECOS PAC ID: 4284996331 Enrollment ID: I20181129000216 |
| Provider Name | Madison Mb Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679993083 PECOS PAC ID: 1254675218 Enrollment ID: I20181130002339 |
| Provider Name | Rupinder K Legha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578799680 PECOS PAC ID: 5597938381 Enrollment ID: I20181204000942 |
| Provider Name | Gowri G Aragam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336552439 PECOS PAC ID: 6608094925 Enrollment ID: I20181205002937 |
| Provider Name | Anjali L Varigonda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942629894 PECOS PAC ID: 4082916671 Enrollment ID: I20181206000202 |
| Provider Name | John P Daly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174950992 PECOS PAC ID: 5799029492 Enrollment ID: I20181206003248 |
| Provider Name | John Teal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972897999 PECOS PAC ID: 6204095284 Enrollment ID: I20181210002921 |
| Provider Name | Joshua Kane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033271747 PECOS PAC ID: 9638205875 Enrollment ID: I20181214001924 |
| Provider Name | Zahra Naqvi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568881423 PECOS PAC ID: 8628313566 Enrollment ID: I20181220000914 |
| Provider Name | Kurt N Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063830149 PECOS PAC ID: 3476774563 Enrollment ID: I20181226001917 |
| Provider Name | Tarek Adam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053722736 PECOS PAC ID: 3870838311 Enrollment ID: I20190102002559 |
| Provider Name | Ladan Hariri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689022477 PECOS PAC ID: 4587909023 Enrollment ID: I20190102002661 |
| Provider Name | Shakevia V Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104236850 PECOS PAC ID: 5092008052 Enrollment ID: I20190107000277 |
| Provider Name | David S Grunwald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437592623 PECOS PAC ID: 7012238553 Enrollment ID: I20190207001669 |
| Provider Name | Jeffrey B Caplan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629182969 PECOS PAC ID: 2567547375 Enrollment ID: I20190212000979 |
| Provider Name | Andrew F Archer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447670245 PECOS PAC ID: 2466672811 Enrollment ID: I20190529002509 |
| Provider Name | Dyani Loo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245573476 PECOS PAC ID: 7214168681 Enrollment ID: I20190722001333 |
| Provider Name | Marcel Green |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891076329 PECOS PAC ID: 2961776117 Enrollment ID: I20191010001475 |
| Provider Name | Mario A Mangiardi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023490828 PECOS PAC ID: 6507198371 Enrollment ID: I20191028002149 |
| Provider Name | Nolan Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811339641 PECOS PAC ID: 5991939282 Enrollment ID: I20200407002635 |
| Provider Name | Kairav Rameshchandra Shah |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1053660886 PECOS PAC ID: 7911123740 Enrollment ID: I20200706001363 |
| Provider Name | Ritika Kaula |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588045140 PECOS PAC ID: 6507179835 Enrollment ID: I20200727003225 |
| Provider Name | Felix E Kral |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306985114 PECOS PAC ID: 2567436447 Enrollment ID: I20200831000441 |
| Provider Name | Bradley Dane Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639559677 PECOS PAC ID: 3971807587 Enrollment ID: I20200929001122 |
| Provider Name | Samuel B Viglietta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679937759 PECOS PAC ID: 6103163142 Enrollment ID: I20201103001943 |
| Provider Name | Balveen Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164753745 PECOS PAC ID: 4183809718 Enrollment ID: I20201229002862 |
| Provider Name | Kimberlee Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306134929 PECOS PAC ID: 3678890563 Enrollment ID: I20210625001428 |
| Provider Name | Deniz Doruk Camsari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043674716 PECOS PAC ID: 5890087951 Enrollment ID: I20210913000784 |
| Provider Name | Raghu Kiran Appasani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023594850 PECOS PAC ID: 2163812504 Enrollment ID: I20211129002623 |
| Provider Name | Mercy Perdomo Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376997502 PECOS PAC ID: 3072808054 Enrollment ID: I20211206000789 |
| Provider Name | Gurmehr Kaur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417452913 PECOS PAC ID: 4284031683 Enrollment ID: I20220523000735 |
| Provider Name | Tyler J Torrico |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083243125 PECOS PAC ID: 2365810793 Enrollment ID: I20221116001285 |
| Provider Name | Tony Thomas Abraham |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1609432061 PECOS PAC ID: 5193115830 Enrollment ID: I20230403002564 |
| Provider Name | Hadijat Wemmy Audu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013544790 PECOS PAC ID: 2365807153 Enrollment ID: I20230501001253 |
| Provider Name | Ramail Danish Siddiqui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366061194 PECOS PAC ID: 5698153625 Enrollment ID: I20230918002702 |
| Provider Name | Simon A Allo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780204214 PECOS PAC ID: 2062866510 Enrollment ID: I20231002003175 |
| Provider Name | Kyle Hendrie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720549827 PECOS PAC ID: 1658607205 Enrollment ID: I20231218000588 |
Clb Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 W 3rd St, D-250, Santa Rosa, CA 95401 Phone: 707-566-7571 | |
Sonoma County Indian Health Project Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 144 Stony Point Rd, Santa Rosa, CA 95401 Phone: 707-521-4545 | |
Cross Cultural Services And Evaluations, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1550 Airport Blvd Ste 206, Santa Rosa, CA 95403 Phone: 707-799-4274 | |
Mounir Belcadi, Md Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3452 Mendocino Ave, Suite C, Santa Rosa, CA 95403 Phone: 707-579-8703 Fax: 707-579-8755 | |
Drug Abuse Alternatives Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2403 Professional Dr, Santa Rosa, CA 95403 Phone: 707-544-3295 | |
Surgical Neuromonitoring Service Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3005 Santa Margarita Ct, Santa Rosa, CA 95405 Phone: 707-573-2341 Fax: 707-539-2939 | |
Lifeworks Of Sonoma County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1260 N Dutton Ave Ste 220, Santa Rosa, CA 95401 Phone: 707-568-2300 Fax: 707-568-2304 |