Healthcare Provider Details
I. General information
NPI: 1154207082
Provider Name (Legal Business Name): COUNTY OF SOLANO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
740 BECK AVE
FAIRFIELD CA
94533-4440
US
IV. Provider business mailing address
475 UNION AVE
FAIRFIELD CA
94533-6319
US
V. Phone/Fax
- Phone: 707-784-6570
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIVIVE
VENZON
Title or Position: DIRECTOR OF AMIN SERVICES
Credential:
Phone: 707-784-7651