1386647857 NPI number — CITY OF SONOMA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386647857 NPI number — CITY OF SONOMA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF SONOMA
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:
6
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:
1386647857
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
#1 THE PLAZA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SONOMA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95476-6901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-938-3681
Provider Business Mailing Address Fax Number:
707-938-2559

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 SECOND STREET WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SONOMA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95476-6901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-996-2102
Provider Business Practice Location Address Fax Number:
707-996-2868
Provider Enumeration Date:
05/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GIOVANATTO
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
ELIZABETH
Authorized Official Title or Position:
CHIEF FINANCIAL OFF.
Authorized Official Telephone Number:
707-933-2213

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: MTE00448F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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