Provider Demographics
NPI:1467664789
Name:COUNTY OF SOLANO
Entity Type:Organization
Organization Name:COUNTY OF SOLANO
Other - Org Name:YOUTH SERVICES-VALLEJO
Other - Org Type:Other Name
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 # MS 5-215
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:707-784-8575
Mailing Address - Fax:404-421-3207
Practice Address - Street 1:355 TUOLUMNE ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5700
Practice Address - Country:US
Practice Address - Phone:707-553-5810
Practice Address - Fax:707-553-5824
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SOLANO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-07
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251B00000X, 251S00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4875Medicaid