LYDIA HASBROUCK MERTENS (NPI# 1366592172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366592172 |
| Entity Type | Individual |
| Full Name | LYDIA HASBROUCK MERTENS |
| Credential | MD |
| Practice Address |
6800 Palm Avenue Suite C Sebastopol CA 95472 |
| Practice Telephone | 7078249999 |
| Mailing Telephone | 7078249999 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2015-12-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | G61214 | CA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | G61214 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G612140 | 05 |
| Street Address |
6800 PALM AVENUE SUITE C |
| City | SEBASTOPOL |
| State | CA |
| Zip Code | 95472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558916791 | Mellisa Nicole Elrod | Occupational Therapist | 1935 Gravenstein Hwy, Sebastopol, CA 95472 | 2019-08-05 |
| 1457820987 | Isabel Brooke Martinez | Acupuncturist | 961 Gravenstein Hwy South, # 100, Sebastopol, CA 95472 | 2018-11-14 |
| 1275025470 | Shahbano Syeda | Specialist/Technologist | 846/848 Gravenstein Hwy South, Sebastopol, CA 95472 | 2018-06-04 |
| 1467990812 | Mathew Metzgar | Marriage & Family Therapist | 1800 N. Gravenstein Hwy, Sebastopol, CA 95472 | 2017-02-06 |
| 1760939318 | Andrea Kirk | Psychologist | 876 Gravenstein Hwy S., Suite 6, Sebastopol, CA 95472 | 2016-09-01 |
| 1548629371 | Stacy Simons | Massage Therapist | 103 Morris St Ste V, Sebastopol, CA 95472 | 2016-02-22 |
| 1619341880 | Carol Schmid | Counselor | 1800 N, Gravenstein Hwy, Sebastopol, CA 95472 | 2015-11-25 |
| 1801273727 | Aaron Martinez | Specialist/Technologist | 7441 Witter Road, Sebastopol, CA 95472 | 2015-04-29 |
| 1699167049 | Nia Kaye | Marriage & Family Therapist | 130 Petaluma Ave Ste 2c, Sebastopol, CA 95472 | 2015-02-23 |
| 1497091383 | Caitlin Marie Kirkman | Midwife | 5611 Hessel Ave, Sebastopol, CA 95472 | 2012-12-20 |
| Find all providers in zip 95472 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689873184 | Kambria Beck Holder | Family Medicine | 652 Petaluma Ave Ste F, Sebastopol, CA 95472-4266 | 2007-07-13 |
| 1598989832 | Yolanda Marie-madeleine Seys | Family Medicine | 2265 Schaeffer Rd, Sebastopol, CA 95472-5500 | 2007-04-11 |
| 1477676336 | Timothy J Smith | Family Medicine | 5281 Thomas Rd, Sebastopol, CA 95472-9374 | 2007-04-07 |
| 1053483107 | Ralph Llewellyn Pendleton | Family Medicine | 10509 Mill Station Rd, Sebastopol, CA 95472-9657 | 2006-11-14 |
| 1316021645 | Constance J. Ayers | Family Medicine | 652 Petaluma Blved., Suite H, Sebastopol, CA 95472 | 2006-10-24 |
| 1285722819 | Andrew Stephen Wagner | Family Medicine | 819 Longwood Ln, Sebastopol, CA 95472-2734 | 2006-10-10 |
| 1235225194 | Gary Ronald Herzberg | Family Medicine | 591 Swain Woods Ter, Sebastopol, CA 95472-4379 | 2006-10-05 |
| 1871690057 | Siskiyou Rural Housecalls Medical Corporation | Family Medicine | 1296 Scheibel Ln, Sebastopol, CA 95472-4717 | 2006-09-20 |
| 1558474270 | Gerald Eugene Eliaser | Family Medicine | 258 Washington Ct, Sebastopol, CA 95472-3170 | 2006-08-16 |
| 1134133085 | Peter V. Madill, M.d. A Medical Corporation | Family Medicine | 1020 Gravenstein Hwy. So., Suite 120, Sebastopol, CA 95472-4569 | 2006-07-28 |
| Find all providers in SEBASTOPOL | ||||
| City | SEBASTOPOL |
| Zip Code | 95472 |
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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.