Provider Demographics
NPI:1063728145
Name:SONOMA COUNTY JUNIOR COLLEGE DISTRICT
Entity type:Organization
Organization Name:SONOMA COUNTY JUNIOR COLLEGE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP ADMINISTRATION AND FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-527-4413
Mailing Address - Street 1:1501 MENDOCINO AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4395
Mailing Address - Country:US
Mailing Address - Phone:707-527-4445
Mailing Address - Fax:707-524-1858
Practice Address - Street 1:1501 MENDOCINO AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4395
Practice Address - Country:US
Practice Address - Phone:707-527-4445
Practice Address - Fax:707-524-1858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health