Organization
SONOMAMODELX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE LATIFI (LICENSEE)
(415) 264-5486
Entity
Organization
Contact information
Practice address
765 DONALD ST, SONOMA, CA 95476-4604
(415) 264-5486
Mailing address
765 DONALD ST, SONOMA, CA 95476-4604
(415) 264-5486
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/23/2023
Last updated
05/23/2023
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