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Individual

JACOB BENJAMIN SOLED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
2235 CHALLENGER WAY, SANTA ROSA, CA 95407-5458
(707) 565-4900
Mailing address
5554 THOMAS RD, SEBASTOPOL, CA 95472-9377
(513) 509-5720

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
283910
NC
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN95171379
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95026966
CA

Other

Enumeration date
08/06/2019
Last updated
03/22/2024
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