Healthcare Provider Details

I. General information

NPI: 1295928448
Provider Name (Legal Business Name): JAMIE ROBERTA YONASH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WIKIUP DR STE 1
SANTA ROSA CA
95403-1375
US

IV. Provider business mailing address

101 WIKIUP DR
SANTA ROSA CA
95403-1375
US

V. Phone/Fax

Practice location:
  • Phone: 707-545-2700
  • Fax:
Mailing address:
  • Phone: 707-545-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: