Provider Demographics
NPI:1073326336
Name:ROOTS, THENEDRA
Entity type:Individual
Prefix:
First Name:THENEDRA
Middle Name:
Last Name:ROOTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 FILBERT WAY
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-2007
Mailing Address - Country:US
Mailing Address - Phone:507-995-8917
Mailing Address - Fax:
Practice Address - Street 1:232 MONTEREY ST STE 240
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3409
Practice Address - Country:US
Practice Address - Phone:831-647-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty