TRACEY L AIRTH-EDBLOM (NPI# 1053571307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053571307 |
| Entity Type | Individual |
| Full Name | TRACEY L AIRTH-EDBLOM |
| Credential | OTR/L, CHT |
| Practice Address |
226 Weller St Petaluma CA 94952-3136 |
| Mailing Address |
8 Pacific Dr Novato CA 94949-5479 |
| Practice Telephone | 7077627678 |
| Practice Fax Number | 7077627679 |
| Mailing Telephone | 4153828202 |
| Mailing Fax Number | 4153828212 |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225XH1200X |
Occupational Therapist Specialization: Hand |
OT345 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
226 WELLER ST |
| City | PETALUMA |
| State | CA |
| Zip Code | 94952-3136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558502393 | Dale B Phillips | Physical Therapist | 226 Weller St, Petaluma, CA 94952-3136 | 2009-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587680 | Benjamin R Idarius | Behavior Technician | 101 H St. Ste. L, Petaluma, CA 94952 | 2019-06-17 |
| 1518457159 | Kyleen Joan Romero | Behavioral Analyst | 25 Graylawn Ave, Petaluma, CA 94952 | 2018-05-17 |
| 1437647526 | John Scruggs | Behavior Technician | 301 H St. Suit L, Petaluma, CA 94952 | 2018-04-25 |
| 1811404684 | Brief and Strategic Counseling Service | Counselor | 843 Chardonnay Cir., Petaluma, CA 94952 | 2018-01-03 |
| 1730638396 | Jennifer Lee Sloan | Acupuncturist | 517 Hayes Lane, Petaluma, CA 94952 | 2016-09-23 |
| 1982057295 | Elene Hwa-yihg Chung | Acupuncturist | 130 Graylawn Ave.,#f, Petaluma, CA 94952 | 2016-07-21 |
| 1457773624 | Lisa Hirsch Cordeiro | Marriage & Family Therapist | 700 Sixth Street, Petaluma, CA 94952 | 2014-01-07 |
| 1811271075 | Jacques Philippe Archer | Massage Therapist | 131b Kentucky St., Petaluma, CA 94952 | 2011-10-06 |
| 1477841609 | Karna Licia Dawson | Social Worker | 205 Keller St., Petaluma, CA 94952 | 2011-07-21 |
| 1497051783 | Melissa Beth Wilson | Acupuncturist | 155a Kentucky Street, Petaluma, CA 94952 | 2011-02-03 |
| Find all providers in zip 94952 | ||||
| Taxonomy Code | 225XH1200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| Specialization | Hand |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568559 | Mary Jean Allan | Occupational Therapist | 1070 Crestline Cir, El Dorado Hills, CA 95762-7223 | 2020-11-05 |
| 1154957280 | Jennifer Marie Macintire | Occupational Therapist | 7000 East Ave # B663l723, Livermore, CA 94550-9698 | 2020-03-20 |
| 1699324988 | Gabriela Garcia | Occupational Therapist | 15311 Gundry Ave Unit 11, Paramount, CA 90723-3987 | 2019-09-09 |
| 1720648298 | Josephine Mickelsen | Occupational Therapist | 22961 Soledad Canyon Rd, Santa Clarita, CA 91350-2633 | 2019-06-17 |
| 1376109108 | Bryan Kang | Occupational Therapist | 2411 Vanderbilt Ln # B, Redondo Beach, CA 90278-3213 | 2019-05-16 |
| 1104383074 | Hand Rehab Pros Antelope Valley | Occupational Therapist | 1037 E Palmdale Blvd Ste 201, Palmdale, CA 93550-4745 | 2019-02-26 |
| 1154886513 | Christine Clermont | Occupational Therapist | 1025 Service Pl, Vista, CA 92084-7200 | 2019-02-09 |
| 1831662287 | Arshia Mohamadi | Occupational Therapist | 2211 W Magnolia Blvd Ste 295, Burbank, CA 91506-1753 | 2019-01-09 |
| 1609354752 | Leigha Holtzhouser | Occupational Therapist | 15525 Pomerado Rd Ste C8, Poway, CA 92064-2426 | 2018-07-31 |
| 1669978292 | Brian David Van Der Wyk | Occupational Therapist | 9819 Nadine St, Temple City, CA 91780-2621 | 2018-04-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.