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
Fax: (707) 565-8190
Website:

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427110741 NPPES
North Carolina MEDICAID 7301830

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