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NPI Code Detail

MEDICARE: LIFEWORKS OF SONOMA COUNTY

MEDICARE: LIFEWORKS OF SONOMA COUNTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyPSY 13055CA
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1033329487
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFEWORKS OF SONOMA COUNTY
Provider Business Mailing Address
First Line : 1200 COLLEGE AVENUE
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-3908
Country : US
Telephone Number : 707-568-2300
Fax Number : 707-568-2304
Provider Business Practice Location Address
First Line : 5450 SNYDER LANE
Second Line :
City : ROHNERT PARK
State : CA
Zip : 94928-2906
Country : US
Telephone Number : 707-792-6506
Fax Number : 707-792-4758
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. JILL W. ROYCE
Credential :
Telephone Number : 707-568-2300
Provider Enumeration Date : 05/23/2007
Last Update Date : 08/12/2010

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Directions to “LIFEWORKS OF SONOMA COUNTY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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