Provider Demographics
NPI:1225112790
Name:SOLANO COUNTY
Entity Type:Organization
Organization Name:SOLANO COUNTY
Other - Org Name:LOMA VISTA MTU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:H&SS CHIEF DEP ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:GIRLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JARUMAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-784-8387
Mailing Address - Street 1:275 BECK AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6804
Mailing Address - Country:US
Mailing Address - Phone:707-784-8657
Mailing Address - Fax:707-421-7484
Practice Address - Street 1:146 RAINIER AVE
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-1846
Practice Address - Country:US
Practice Address - Phone:707-643-2954
Practice Address - Fax:707-642-1842
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SOLANO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-24
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACCS00067FMedicaid
CACCS00067FMedicaid
CAZZZ28053ZMedicare PIN
CAZZZ28061ZMedicare PIN