Dikeman, Tara Lynn
Dikeman, Tara Lynn is an individual health care provider with primary practice located at 2665 A Dutton Meadow Ave , Santa Rosa CA 95407-7730. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Dikeman, Tara Lynn can be contacted via phone (707) 565-8185.Contact Information
Primary practice address
2665 A Dutton Meadow Ave
Santa Rosa CA 95407-7730
Phone: (707) 565-8185
Fax: (707) 565-8190
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 5765 | North Carolina |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 5905 | California |
Profile Details
NPI number | 1427110741 |
---|---|
LBN Legal business name | Dikeman, Tara Lynn |
Credentials | M.ED.,OTR |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 14th, 2006 |
Last updated | Feb 4th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1427110741 | NPPES |
North Carolina | MEDICAID | 7301830 |
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