Healthcare Provider Details

I. General information

NPI: 1689883902
Provider Name (Legal Business Name): COUNTY OF SOLANO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 COURAGE DR # MS 9-200
FAIRFIELD CA
94533-6733
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 707-784-4410
  • Fax: 707-553-5658
Mailing address:
  • Phone: 707-784-8575
  • Fax: 707-421-3207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number05D0600176
License Number StateCA

VIII. Authorized Official

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