Organization
SONOMA VALLEY COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL K JOHNSON (CEO)
(707) 939-6075
Entity
Organization
Contact information
Practice address
19270 SONOMA HIGHWAY 12, SONOMA, CA 95476-5414
(707) 939-6070
(707) 939-6077
Mailing address
19270 SONOMA HIGHWAY 12, SONOMA, CA 95476-5414
(707) 939-6070
(707) 939-6077
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
110000251
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0903302
CLIA
CA
01
—
110000251
CLINIC LICENSE
CA
05
—
BCP53855F
—
CA
05
—
EAP53855F
—
CA
05
—
FHC53855F
—
CA
05
—
GR0085520
—
CA
05
—
HAP53855F
—
CA
Enumeration date
10/31/2006
Last updated
07/03/2014
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