Healthcare Provider Details

I. General information

NPI: 1689792780
Provider Name (Legal Business Name): COUNTY OF TUOLUMNE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL RD VNA ML FAC - ADHC
SONORA CA
95370-5227
US

IV. Provider business mailing address

101 HOSPITAL RD NPI COORDINATOR
SONORA CA
95370-5227
US

V. Phone/Fax

Practice location:
  • Phone: 209-533-7100
  • Fax:
Mailing address:
  • Phone: 209-533-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: SARA HERRIN
Title or Position: CEO
Credential:
Phone: 209-532-7166