Provider Demographics
NPI:1457170813
Name:COUNTY OF SONOMA
Entity type:Organization
Organization Name:COUNTY OF SONOMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position: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 1:7425 RANCHO LOS GUILICOS RD DEPT A
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409-6530
Mailing Address - Country:US
Mailing Address - Phone:707-565-6300
Mailing Address - Fax:
Practice Address - Street 1:7425 RANCHO LOS GUILICOS RD DEPT A
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95409-6530
Practice Address - Country:US
Practice Address - Phone:707-565-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SONOMA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)