Healthcare Provider Details

I. General information

NPI: 1083845275
Provider Name (Legal Business Name): COUNTY OF SOLANO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 COURAGE DRIVE
FAIRFIELD CA
94533-6717
US

IV. Provider business mailing address

275 BECK AVE # MS 5210
FAIRFIELD CA
94533-6804
US

V. Phone/Fax

Practice location:
  • Phone: 707-784-2010
  • Fax: 707-435-2032
Mailing address:
  • Phone: 707-784-8575
  • Fax: 707-421-6759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: GIRLIE JARUMAY
Title or Position: H&SS CHIEF DEP ADMINISTRATION
Credential:
Phone: 707-784-8387