1740402452 NPI number — COUNTY OF SOLANO

Table of content: (NPI 1740402452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740402452 NPI number — COUNTY OF SOLANO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF SOLANO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SCMH NORTH COUNTY SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740402452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 BECK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94533-6804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-784-8573
Provider Business Mailing Address Fax Number:
707-421-6759

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1119 E MONTE VISTA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VACAVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95688-3009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-469-4540
Provider Business Practice Location Address Fax Number:
707-469-4560
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JARUMAY
Authorized Official First Name:
GIRLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
H&SS CHIEF DEP ADMINISTRATION
Authorized Official Telephone Number:
707-784-8387

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4885 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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