Provider Demographics
NPI:1467661843
Name:COUNTY OF SONOMA
Entity Type:Organization
Organization Name:COUNTY OF SONOMA
Other - Org Name:FEE FOR SERVICE LCSW
Other - Org Type:Other Name
Authorized Official - Title/Position:DEPARTMENT ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-565-7846
Mailing Address - Street 1:1450 NEOTOMAS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-7574
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1450 NEOTOMAS AVE STE 200
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7574
Practice Address - Country:US
Practice Address - Phone:707-565-4861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4981OtherLCSW FFS PROVIDER NUMBER