MEDICARE: SOLANO COUNTY CCS

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
1	261QR0400X	Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619051166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLANO COUNTY CCS

Provider Business Mailing Address
First Line	:	275 BECK AVE # MS 5-215
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-6804
Country	:	US
Telephone Number	:	770-778-4857
Fax Number	:	707-421-3207

Provider Business Practice Location Address
First Line	:	1895 WOOLNER AVE
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-5807
Country	:	US
Telephone Number	:	707-422-3376
Fax Number	:	707-422-4315

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	04/10/2024

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Directions to “SOLANO COUNTY CCS ” Practice Location

Language	Start Address	Practice Location

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