1952637027 NPI number — COUNTY 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 1952637027 NPI number — COUNTY OF SONOMA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY 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:
1952637027
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5350 OLD REDWOOD HIGHWAY, N
Provider Second Line Business Mailing Address:
SUITE 600
Provider Business Mailing Address City Name:
PETALUMA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94954-1177
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
707-894-4715
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 S CLOVERDALE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLOVERDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95425-3710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-894-4715
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ZHANG
Authorized Official First Name:
RUBY
Authorized Official Middle Name:
Authorized Official Title or Position:
DEPARTMENT ANALYST
Authorized Official Telephone Number:
707-565-7846

Provider Taxonomy Codes

  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 49FP . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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