Healthcare Provider Details

I. General information

NPI: 1982890042
Provider Name (Legal Business Name): CARLA ALLISON MULL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARLA MULL PA-C

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 STONY POINT RD
SANTA ROSA CA
95401-4122
US

IV. Provider business mailing address

144 STONY POINT RD
SANTA ROSA CA
95401-4122
US

V. Phone/Fax

Practice location:
  • Phone: 707-521-4500
  • Fax:
Mailing address:
  • Phone: 707-521-4500
  • Fax: 707-544-4626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA19160
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: