Healthcare Provider Details

I. General information

NPI: 1932176146
Provider Name (Legal Business Name): ADVENTIST HEALTH ST. HELENA OB/GYN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 RAILROAD AVE
SAINT HELENA CA
94574-1106
US

IV. Provider business mailing address

1530 RAILROAD AVE
SAINT HELENA CA
94574-1106
US

V. Phone/Fax

Practice location:
  • Phone: 707-963-5006
  • Fax: 707-963-9185
Mailing address:
  • Phone: 707-963-5006
  • Fax: 707-963-9185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: RENEE W SOLOMON
Title or Position: MEDICAL GROUP COORDINATOR
Credential:
Phone: 707-968-2870