Provider Demographics
NPI:1154006039
Name:STRAATSMA, GREER
Entity type:Individual
Prefix:
First Name:GREER
Middle Name:
Last Name:STRAATSMA
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 1:64 CHARRO DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-9031
Mailing Address - Country:US
Mailing Address - Phone:707-490-7884
Mailing Address - Fax:
Practice Address - Street 1:19375 HWY 116
Practice Address - Street 2:
Practice Address - City:MONTE RIO
Practice Address - State:CA
Practice Address - Zip Code:95462
Practice Address - Country:US
Practice Address - Phone:707-865-1200
Practice Address - Fax:707-865-5122
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA137689106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist