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General NPI Number Information
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NPI Number | 1639991581
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Entity Type | Organization
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Legal Business Name | COUNTY OF SONOMA
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 2227 CAPRICORN WAY, SUITES 207, 211, 213
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City | SANTA ROSA
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State | CA
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Zip | 95407
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Country | US
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Telephone | 707-565-4810
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Fax |
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Provider Business Mailing Address
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Address Line | 2227 CAPRICORN WAY, SUITES 207, 211, 213
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City | SANTA ROSA
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State | CA
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Zip | 95407
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Country | US
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Telephone | 707-565-4810
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Fax |
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Authorized Official
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Title or Position | RMU MANAGER
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Name | SEAN BARKER
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Credential |
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Telephone | 707-565-2637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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