Provider Demographics
NPI:1376674887
Name:COUNTY OF HUMBOLDT
Entity Type:Organization
Organization Name:COUNTY OF HUMBOLDT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH BRANCH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-268-2121
Mailing Address - Street 1:529 I ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1116
Mailing Address - Country:US
Mailing Address - Phone:707-445-6200
Mailing Address - Fax:707-445-6097
Practice Address - Street 1:529 I ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1116
Practice Address - Country:US
Practice Address - Phone:707-445-6200
Practice Address - Fax:707-445-6097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR11483FMedicaid
CAZZR11483FMedicaid