Healthcare Provider Details

I. General information

NPI: 1003089558
Provider Name (Legal Business Name): SONOMA NATUROPATHIC MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 W NAPA ST SUITE 1
SONOMA CA
95476-6408
US

IV. Provider business mailing address

710 W NAPA ST SUITE 1
SONOMA CA
95476-6408
US

V. Phone/Fax

Practice location:
  • Phone: 707-996-9355
  • Fax: 707-996-9356
Mailing address:
  • Phone: 707-996-9355
  • Fax: 707-996-9356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number294
License Number StateCA

VIII. Authorized Official

Name: DR. REBECCA H PORRINO
Title or Position: NATUROPATHIC DOCTOR-- CO-OWNER
Credential: N.D.
Phone: 707-996-9355