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General NPI Number Information
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NPI Number | 1083754998
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/09/2018
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Provider Practice Location Address
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Address Line | 3300 RENNER DR
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City | FORTUNA
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State | CA
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Zip | 95540
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Country | US
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Telephone | 707-725-7332
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Fax | 707-725-7235
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Provider Business Mailing Address
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Address Line | 3300 RENNER DR
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City | FORTUNA
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State | CA
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Zip | 95540-3120
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Country | US
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Telephone | 707-725-7332
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Fax | 707-725-7235
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Authorized Official
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Title or Position | AREA DIRECTOR, REVENUE CYCLE
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Name | MARIE ANTOINETTE SORCI
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Credential |
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Telephone | 707-269-4278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | HSP40639
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License Number State | CA
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