Provider Demographics
NPI:1699941914
Name:PREGNANCY COUNSELING CENTER OF SONOMA COUNTY
Entity type:Organization
Organization Name:PREGNANCY COUNSELING CENTER OF SONOMA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/ NURSE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:LUDERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:707-575-3429
Mailing Address - Street 1:750 MENDOCINO AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4846
Mailing Address - Country:US
Mailing Address - Phone:707-575-3429
Mailing Address - Fax:707-575-1617
Practice Address - Street 1:750 MENDOCINO AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4846
Practice Address - Country:US
Practice Address - Phone:707-575-3429
Practice Address - Fax:707-575-1617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0093600OtherMEDI-CAL GROUP NUMBER