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Contact Information

TRADITIONS PSYCHIATRY GROUP, P.C
1287 FULTON RD
SANTA ROSA, CA95401-4923
 Phone: 707-258-8757
 Fax: 707-253-0457
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for TRADITIONS PSYCHIATRY GROUP PC · (Female)

NPI # 1083802979
Status Active
Credentials
Entity Individual
Enumeration date 10/04/2007
Last updated 04/03/2026 - About 2 months ago
Sole proprietor 1 Not specified
Identifiers
  • CA Medicaid GPS001190
  • CA Other CA298849 MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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