1033241112 NPI number — YOLO COUNTY HEALTH AND HUMAN SERVICES AGENCY

Table of content: MR. CARL RUSSELL GOLDEN JR. (NPI 1255459202)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033241112 NPI number — YOLO COUNTY HEALTH AND HUMAN SERVICES AGENCY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOLO COUNTY HEALTH AND HUMAN SERVICES AGENCY
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:
Provider Other Organization Name Type Code:
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:
1033241112
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
137 N. COTTONWOOD STREET
Provider Second Line Business Mailing Address:
SUITE 2500 - ADMIN
Provider Business Mailing Address City Name:
WOODLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95695
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-666-8516
Provider Business Mailing Address Fax Number:
530-666-8294

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 JEFFERSON BLVD # B
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
WEST SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95605-2350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-375-6350
Provider Business Practice Location Address Fax Number:
916-375-6355
Provider Enumeration Date:
03/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BARRETT
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
Authorized Official Title or Position:
BEHAVIORAL HEALTH COMPLIANCE OFFICE
Authorized Official Telephone Number:
530-666-8983

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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