DR. ELYSE RAE EISENBERG (NPI# 1316966815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316966815 |
| Entity Type | Individual |
| Full Name | DR. ELYSE RAE EISENBERG |
| Credential | M.D. |
| Practice Address |
725 Farmers Ln Ste 10 Santa Rosa CA 95405-6710 |
| Mailing Address |
6114 La Salle Ave 438 Oakland CA 94611-2802 |
| Practice Telephone | 7075233375 |
| Practice Fax Number | 8668700815 |
| Mailing Telephone | 7075233375 |
| Mailing Fax Number | 8668700815 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-01-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
G64542 | CA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | G64542 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
725 FARMERS LN STE 10 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-6710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619363207 | Georgia Anne Berry | Marriage & Family Therapist | 725 Farmers Ln, Suite 15, Santa Rosa, CA 95405-6710 | 2015-04-09 |
| 1003225061 | Elyse R. Eisenberg, Md, Inc. | Clinic/Center | 725 Farmers Ln, Ste 10, Santa Rosa, CA 95405-6710 | 2014-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497954911 | Elyse R. Eisenberg Md, Inc. | Family Medicine | 725 Farmers Ln Ste 10, Santa Rosa, CA 95405-6743 | 2007-07-13 |
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|---|---|---|---|---|
| 1194332726 | True North Detox LLC | Family Medicine | 2413 Whitmore Ave, Clovis, CA 93619-9252 | 2020-09-28 |
| 1639717473 | Michael Stone Md Inc | Family Medicine | 1950 E 17th St Ste 101, Santa Ana, CA 92705-6852 | 2019-12-11 |
| 1720624497 | Marina Harbor Detox | Family Medicine | 289 Marina Blvd, San Francisco, CA 94123-1212 | 2019-11-18 |
| 1093363848 | Anthony Martin Ocana | Family Medicine | 13924 Marquesas Way Apt 1520, Marina Del Rey, CA 90292-6018 | 2019-08-26 |
| 1821640137 | L Snyder Incorporated | Family Medicine | 34052 La Plaza #101, Dana Point, CA 92629 | 2019-07-16 |
| 1720645328 | Creative Child and Family Services, Inc. | Family Medicine | 7049 Ohio River Dr, Eastvale, CA 91752 | 2019-05-20 |
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1629550660 | University of California Sfgh Medical Group | Family Medicine | 1001 Potrero Ave Rm 5h22, San Francisco, CA 94110-3518 | 2018-09-06 |
| 1952809592 | Sunrise Health & Wellness Center, LLC | Family Medicine | 10089 Folsom Blvd. Suites A & C, Rancho Cordova, CA 95670-1935 | 2018-01-29 |
| 1487166120 | Good Samaritan Shelter | Family Medicine | 412 East Tunnell Street, Santa Maria, CA 93454 | 2017-11-03 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.