Healthcare Provider Details

I. General information

NPI: 1215277132
Provider Name (Legal Business Name): ROSA ANGELINA TAPIA-GUTIERREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSA ANGELINA TAPIA BREINING INSTITUTE

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400A COUNTY CENTER DR
SANTA ROSA CA
95403-3004
US

IV. Provider business mailing address

2400A COUNTY CENTER DR
SANTA ROSA CA
95403-3004
US

V. Phone/Fax

Practice location:
  • Phone: 707-565-8053
  • Fax:
Mailing address:
  • Phone: 707-565-8053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number6711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: