Healthcare Provider Details

I. General information

NPI: 1265589808
Provider Name (Legal Business Name): SOLANO COUNTY PUBLIC HEALTH NURSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 BECK AVE
FAIRFIELD CA
94533-6804
US

IV. Provider business mailing address

410 SPYGLASS CT
VACAVILLE CA
95687-7729
US

V. Phone/Fax

Practice location:
  • Phone: 707-784-8090
  • Fax:
Mailing address:
  • Phone: 707-688-6833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number545174
License Number StateCA

VIII. Authorized Official

Name: MRS. JA'NITA MARCHELE BECERRA
Title or Position: REGISTERED NURSE
Credential: RN
Phone: 707-784-8090