Theresa Louise Mortensen (NPI# 1972683753, PAC ID# 2769377449) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1972683753 |
| PAC ID by PECOS | 2769377449 |
| Professional Enrollment ID | I20040220000454 |
| Full Name | Theresa Louise Mortensen |
| Organization Legal Name | ST JOSEPH HERITAGE HEALTHCARE |
| Address |
3555 Round Barn Cir Santa Rosa CA 95403-1757 |
| Phone Number | 7075281050 |
| Gender | F |
| Credential | NP |
| Graduation Year | 2002 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8921993205 |
| Number of Group Practice Members | 1049 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050174 | SANTA ROSA MEMORIAL HOSPITAL |
| 050136 | PETALUMA VALLEY HOSPITAL |
| 050090 | SONOMA VALLEY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1165 Montgomery Dr, Santa Rosa, CA 95405-4801 | 7075463210 | ST JOSEPH HERITAGE HEALTHCARE |
| 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 | 7075281050 | ST JOSEPH HERITAGE HEALTHCARE |
| Organization Legal Name | ST JOSEPH HERITAGE HEALTHCARE |
| Physicians | 1022 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tarah N Nelson | Nurse Practitioner | St Joseph Heritage Healthcare | 2460 Buhne St, Eureka, CA 95501-3207 |
| Kristen Shay Rasnick | Nurse Practitioner | St Joseph Heritage Healthcare | 6580 Hembree Ln, Suite 270, Windsor, CA 95492-6885 |
| Basit Rahim | Neurology | St Joseph Heritage Healthcare | 26800 Crown Valley Pkwy, Suite 385, Mission Viejo, CA 92691-7320 |
| Elizabeth Wachtel O'brien | Certified Nurse Midwife (cnm) | St Joseph Heritage Healthcare | 3307 Renner Dr, Fortuna, CA 95540-3119 |
| Michael James Glamore | Urology | St Joseph Heritage Healthcare | 1701 4th St, Suite 200, Santa Rosa, CA 95404-3661 |
| Teresa E Shields-szabo | Family Medicine | St Joseph Heritage Healthcare | 26795 Portola Pkwy, Foothill Ranch, CA 92610-1713 |
| Austin James Perkins | Physician Assistant | St Joseph Heritage Healthcare | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3816 |
| Sherin Ann Chakkalakel | Nurse Practitioner | St Joseph Heritage Healthcare | 905 E Washington St, St Joseph Heritage Healthcare, Petaluma, CA 94952-3389 |
| Jamie Lea Meyer | Nurse Practitioner | St Joseph Heritage Healthcare | 2332 23rd St, Eureka, CA 95501-3231 |
| Laura Elizabeth Hall | Nurse Practitioner | St Joseph Heritage Healthcare | 2280 Harrison Ave, Suite K, Eureka, CA 95501-3200 |
| Street Address |
3555 ROUND BARN CIR |
| City | SANTA ROSA |
| State | CA |
| Zip | 95403-1757 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jarrod Paul Holmes | Medical Oncology | St Joseph Heritage Healthcare | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 |
| Leroy Wayne Keiser | Medical Oncology | St Joseph Heritage Healthcare | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 |
| Ian Churchhill Anderson | Hematology/oncology | St Joseph Heritage Healthcare | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 |
| Thomas S Stanton Ii | Medical Oncology | St Joseph Heritage Healthcare | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 |
| Manasa Vulchi | Medical Oncology | St Joseph Heritage Healthcare | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 |
| Lorraine Anne Champion | Pediatric Medicine | St Joseph Heritage Healthcare | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Maayan E Lieberman | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Anthony K Boyce | Family Medicine | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Elisabeth H Brittell | Psychologist, Clinical | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Olga G Sokolova | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Christine L Bilbrey | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Fredysha S Mcdaniel | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Emily L Porch | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Armand Braun | Psychiatry | Permanente Medical Group Inc | 3554 Round Barn Blvd, Santa Rosa, CA 95403-0929 |
| Sonya M Kelly | Psychologist, Clinical | 3558 Round Barn Blvd, Suite 200, Santa Rosa, CA 95403-0991 | |
| Alison B Valdovinos | Clinical Psychologist | 3558 Round Barn Blvd, Santa Rosa, CA 95403-0991 | |
| Find all physicians in zip 95403 | |||
| City | SANTA ROSA |
| Zip Code | 95403 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SANTA ROSA + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.