Organization
AREA 12 AGENCY ON AGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINE WHITE (EXECUTIVE DIRECTOR)
(209) 532-6272
Entity
Organization
Contact information
Practice address
19074 STANDARD RD STE A, SONORA, CA 95370-7542
(209) 532-6272
(209) 532-6501
Mailing address
19074 STANDARD RD., SUITE A, SONORA, CA 95370
(209) 532-6272
(209) 532-6501
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MSS00032F
—
CA
Enumeration date
11/26/2013
Last updated
11/26/2013
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