Provider Demographics
NPI:1194840280
Name:SONOMA COUNTY OFFICE OF EDUCATION
Entity Type:Organization
Organization Name:SONOMA COUNTY OFFICE OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DATA CONTROL TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUZY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-524-2727
Mailing Address - Street 1:5340 SKYLANE BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-1082
Mailing Address - Country:US
Mailing Address - Phone:707-524-2727
Mailing Address - Fax:707-578-1505
Practice Address - Street 1:5340 SKYLANE BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1082
Practice Address - Country:US
Practice Address - Phone:707-524-2727
Practice Address - Fax:707-578-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS4910496Medicaid