Provider Demographics
NPI:1285451864
Name:COUNTY OF SONOMA
Entity type:Organization
Organization Name:COUNTY OF SONOMA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DHS RMU MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-565-4861
Mailing Address - Street 1:2227 CAPRICORN WAY STE 202
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-5490
Mailing Address - Country:US
Mailing Address - Phone:707-565-4861
Mailing Address - Fax:
Practice Address - Street 1:2227 CAPRICORN WAY STE 202
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-5490
Practice Address - Country:US
Practice Address - Phone:707-565-3049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SONOMA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-24
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health