Healthcare Provider Details

I. General information

NPI: 1679494041
Provider Name (Legal Business Name): MRS. RIMA JAY HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 BEAVER ST. #204 431 BEAVER ST. #204
SANTA ROSA CA
95404
US

IV. Provider business mailing address

431 BEAVER ST. #204 431 BEAVER ST. #204
SANTA ROSA CA
95404
US

V. Phone/Fax

Practice location:
  • Phone: 707-623-0925
  • Fax:
Mailing address:
  • Phone: 707-623-0925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344800000X
TaxonomyAir Carrier
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: