Healthcare Provider Details

I. General information

NPI: 1740035302
Provider Name (Legal Business Name): SUNSHINE ANITA TRESIDDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANITA LEE TRESIDDER LM, CPM, CMT

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 F ST
ARCATA CA
95521-6616
US

IV. Provider business mailing address

PO BOX 46
BAYSIDE CA
95524-0046
US

V. Phone/Fax

Practice location:
  • Phone: 707-684-9586
  • Fax:
Mailing address:
  • Phone: 707-684-9586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number733
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number67041
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: