Organization
DEPARTMENT OF HEALTH SERVICES
Active
Parent organization
COUNTY OF SONOMA DEPT OF HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF SONOMA DEPT OF HEALTH
Authorized official
DIANA STORNETTA (ACCOUNTANT III COMPLIANCE)
(707) 565-4782
Entity
Organization
Contact information
Practice address
155 N. PYTHIAN ROAD, SANTA ROSA, CA 95409
(707) 565-6350
Mailing address
PO BOX 1539, SANTA ROSA, CA 95402-1539
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZR11473F
CALIFORNIA MEDI-CAL
CA
Enumeration date
01/23/2007
Last updated
12/18/2007
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