LIFEWORKS OF SONOMA COUNTY (NPI# 1063557171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063557171 |
| Entity Type | Organization |
| Organization Name | LIFEWORKS OF SONOMA COUNTY |
| Practice Address |
1260 N Dutton Ave Ste 105 & Ste 244 Santa Rosa CA 95401-7121 |
| Practice Telephone | 7075682300 |
| Practice Fax Number | 7075682304 |
| Mailing Telephone | 7075682300 |
| Mailing Fax Number | 7075682304 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2019-09-17 |
| NPI Deactivation Date | 05/28/2015 |
| NPI Reactivation Date | 2015-07-30 |
| Authorized Official Name | MICHELLE FOUNTAIN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7075682300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 College Ave, Santa Rosa, CA 954043908 | 7075632300 | 7075682304 |
| 1260 N Dutton Ave Ste 244, Santa Rosa, CA 954014672 | 7075632300 | 7075682304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396063509 | Lifeworks of Sonoma County | Community/Behavioral Health | 2480 Sebastopol Road, Santa Rosa, CA 95407-6728 | 2010-05-12 |
| 1821254889 | Lifeworks of Sonoma County | Community/Behavioral Health | 1350 Sonoma Avenue, Santa Rosa, CA 95405-6697 | 2008-07-30 |
| 1053522508 | Lifeworks of Sonoma County | Community/Behavioral Health | 5154 Snyder Lane, Rohnert Park, CA 94928-2943 | 2007-05-25 |
| 1528279072 | Lifeworks of Sonoma County | Community/Behavioral Health | 9500 Brooks Road S, Windsor, CA 95492-9217 | 2007-05-25 |
| 1437360989 | Lifeworks of Sonoma County | Community/Behavioral Health | 333 Casa Grande Road, Petaluma, CA 94954-5799 | 2007-05-25 |
| 1619188166 | Lifeworks of Sonoma County | Community/Behavioral Health | 1235 Mendocino Avenue, Santa Rosa, CA 95401-4386 | 2007-05-25 |
| 1033329487 | Lifeworks of Sonoma County | Community/Behavioral Health | 5450 Snyder Lane, Rohnert Park, CA 94928-2906 | 2007-05-23 |
| 1215360540 | Lifeworks of Sonoma County | Community/Behavioral Health | 1200 College Ave, Santa Rosa, CA 95404-3908 | 2013-08-09 |
| 1619295839 | Lifeworks of Sonoma County | Community/Behavioral Health | 1260 N Dutton Ave, Ste 105 & Ste 244, Santa Rosa, CA 95401 | 2010-05-12 |
| Street Address |
1260 N DUTTON AVE STE 105 & STE 244 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95401-7121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134149289 | Richard P. Olcese | Clinical Neuropsychologist | 1260 N Dutton Ave, Suite 245, Santa Rosa, CA 95401-4659 | 2006-07-20 |
| 1720626112 | Samantha Frias | Community Health Worker | 1260 N Dutton Ave, Santa Rosa, CA 95401-4659 | 2019-12-16 |
| 1447748751 | Sean Avila Saiter | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Ave, Santa Rosa, CA 95401-4659 | 2018-04-23 |
| 1295105500 | Allison Faris | Psychologist | 1260 N Dutton Ave, Santa Rosa, CA 95401-4659 | 2015-09-29 |
| 1689093726 | Vergil Hobbs | Clinical Neuropsychologist | 1260 N Dutton Ave, Suite 225, Santa Rosa, CA 95401-4659 | 2014-04-15 |
| 1801224043 | Katherine Whitley | Nurse Practitioner | 1260 N Dutton Ave, #275, Santa Rosa, CA 95401-4659 | 2013-10-25 |
| 1447500756 | Peter Behel | Behavioral Analyst | 1260 N Dutton Ave, 175, Santa Rosa, CA 95401-4659 | 2012-09-13 |
| 1205117876 | Tari Webber | Counselor | 1260 N Dutton Ave, Suite 225, Santa Rosa, CA 95401-4659 | 2011-09-08 |
| 1619295839 | Lifeworks of Sonoma County | Community/Behavioral Health | 1260 N Dutton Ave, Ste 105 & Ste 244, Santa Rosa, CA 95401 | 2010-05-12 |
| 1891927281 | Andrew Evan O'neall | Psychologist | 1260 N Dutton Ave, Ste 225, Santa Rosa, CA 95401-4659 | 2009-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
| 1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
| 1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
| 1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
| 1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
| 1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
| Find all providers in zip 95401 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1730710260 | Harold Joseph Bahr | Counselor | 1550 N Dutton Ave, Santa Rosa, CA 95401-4601 | 2020-02-03 |
| 1801432398 | William Carroll | Counselor | 1260 N Dutton Ave Ste 185, Santa Rosa, CA 95401-7146 | 2019-11-20 |
| 1497390462 | Emily Sue Hamp | Counselor | 1202 Woodlake Dr, Santa Rosa, CA 95405-9217 | 2019-11-13 |
| 1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
| 1174005540 | Amal Saeed Ahmed | Counselor | 2908 Bay Village Cir Apt 2108, Santa Rosa, CA 95403-3611 | 2018-09-03 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1992223192 | Jill Mcculloch | Counselor | 300 Stony Point Rd Apt 190, Santa Rosa, CA 95401-5960 | 2017-09-07 |
| 1497299325 | Janice Anne Myers | Counselor | 3746 Oregon Dr, Santa Rosa, CA 95405-7136 | 2016-12-12 |
| 1689128001 | Wakanda Rose | Counselor | 254 Brey Rd, Santa Rosa, CA 95409-5556 | 2016-08-15 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95401 |
Please comment or provide details below to improve the information on LIFEWORKS OF SONOMA COUNTY.
| 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.