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General NPI Number Information
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NPI Number | 1063728145
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Entity Type | Organization
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Legal Business Name | SONOMA COUNTY JUNIOR COLLEGE DISTRICT
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 1501 MENDOCINO AVE
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City | SANTA ROSA
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State | CA
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Zip | 95401-4395
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Country | US
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Telephone | 707-527-4445
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Fax | 707-524-1858
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Provider Business Mailing Address
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Address Line | 1501 MENDOCINO AVE
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City | SANTA ROSA
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State | CA
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Zip | 95401-4395
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Country | US
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Telephone | 707-527-4445
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Fax | 707-524-1858
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Authorized Official
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Title or Position | VP ADMINISTRATION AND FINANCE
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Name | KATE JOLLEY
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Credential |
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Telephone | 707-527-4413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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