Healthcare Provider Details

I. General information

NPI: 1063893741
Provider Name (Legal Business Name): PATRICIA PIPER DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6422 OLD REDWOOD HWY
SANTA ROSA CA
95403-1158
US

IV. Provider business mailing address

6422 OLD REDWOOD HWY
SANTA ROSA CA
95403-1158
US

V. Phone/Fax

Practice location:
  • Phone: 707-838-3031
  • Fax: 707-838-4905
Mailing address:
  • Phone: 707-838-3031
  • Fax: 707-838-4905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number7222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: