MS. AUDREY BELLE LAND (NPI# 1124547443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124547443 |
| Entity Type | Individual |
| Full Name | MS. AUDREY BELLE LAND |
| Practice Address |
1120 Gordon Ln Santa Rosa CA 95404-5636 |
| Mailing Address |
368 Fell St San Francisco CA 94102-5144 |
| Practice Telephone | 7075273249 |
| Mailing Telephone | 4158610828 |
| Mailing Fax Number | 4158610257 |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2019-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3400 Montgomery Dr, Santa Rosa, CA 954055142 | 7075266902 |
| Street Address |
1120 GORDON LN |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95404-5636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659656205 | Allison M Ball | Counselor | 1120 Gordon Ln, Santa Rosa, CA 95404 | 2011-10-14 |
| 1427668433 | Jasmine Segura | Community Health Worker | 1120 Gordon Ln, Santa Rosa, CA 95404-5636 | 2020-08-04 |
| 1679183693 | Kelsey Theresa O'brien | Community Health Worker | 1120 Gordon Ln, Santa Rosa, CA 95404-5636 | 2020-08-04 |
| 1073121687 | Alexandra Hendricks | Community Health Worker | 1120 Gordon Ln, Santa Rosa, CA 95404-5636 | 2020-07-20 |
| 1699303982 | Tamera Downing-cramer | Community Health Worker | 1120 Gordon Ln, Santa Rosa, CA 95404-5636 | 2020-03-31 |
| 1154951861 | Karli Klaiber | Community Health Worker | 1120 Gordon Ln, Santa Rosa, CA 95404-5636 | 2020-01-22 |
| 1407490360 | Kaitlyn Anne Virden | Community Health Worker | 1120 Gordon Ln, Santa Rosa, CA 95404-5636 | 2019-11-04 |
| 1568013837 | Mary Jayne Coburn | Community Health Worker | 1120 Gordon Ln, Santa Rosa, CA 95404-5636 | 2019-09-26 |
| 1104475805 | Samantha Andrews | Community Health Worker | 1120 Gordon Ln, Santa Rosa, CA 95404-5636 | 2019-09-05 |
| 1255992624 | Tia Cooper | Community Health Worker | 1120 Gordon Ln, Santa Rosa, CA 95404-5636 | 2019-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1366940504 | New Leaf Counseling and Psychotherapy | Marriage & Family Therapist | 1030 2n Street, Suite B, Santa Rosa, CA 95404 | 2018-01-23 |
| 1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
| 1982135992 | Gaea Keridwyn Coon | Marriage & Family Therapist | 884 Third Street, Suite D, Santa Rosa, CA 95404 | 2017-03-22 |
| 1376084699 | Empire Traditional Chinese Medicine | Acupuncturist | 1030 Second St, Santa Rosa, CA 95404 | 2017-03-20 |
| 1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
| 1205295979 | Sandra Lee Krikorian | Social Worker | 101 E Street, Suite 312, Santa Rosa, CA 95404 | 2016-02-23 |
| 1396134615 | The Center for Body Oriented Psychotherapy & Wellness | Psychologist | 1626 Fourth Street, Santa Rosa, CA 95404 | 2015-01-12 |
| Find all providers in zip 95404 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710506381 | Shauna Rose Hamilton | Counselor | 831 Howard St, Santa Rosa, CA 95404-3714 | 2020-04-13 |
| 1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
| 1275066193 | Alyssia Cruz | Counselor | 2245 Challenger Way, Santa Rosa, CA 95407-5418 | 2017-04-07 |
| 1780036780 | Brittany Leigh Ratiani | Counselor | 1421 Guerneville Rd Ste 128, Santa Rosa, CA 95403 | 2016-07-01 |
| 1912378381 | Deborah Dooley | Counselor | 650 Larkfield Ctr # A-3, Santa Rosa, CA 95403-1400 | 2015-10-12 |
| 1669842878 | Kimberly Harris | Counselor | 7425 Los Guilicos Rd., Dept. H, Santa Rosa, CA 95409 | 2015-09-30 |
| 1265808976 | Wilton Hall IIi | Counselor | 3114 Terra Linda Dr, Santa Rosa, CA 95404-2121 | 2015-08-17 |
| 1154752244 | Tara Farrell | Counselor | 123 General Delivery, Santa Rosa, CA 95402-9999 | 2013-11-27 |
| 1225463128 | Laura May | Counselor | 757 Beaver St, Santa Rosa, CA 95404-3755 | 2013-09-10 |
| 1427482348 | Eden Rose Lebold | Counselor | 1230 Impala Ct, Santa Rosa, CA 95405-7323 | 2013-08-27 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95404 |
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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.