Provider Demographics
NPI:1619051166
Name:SOLANO COUNTY CCS
Entity Type:Organization
Organization Name:SOLANO COUNTY CCS
Other - Org Name:T.C.MCDANIEL 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 # 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:770-778-4857
Mailing Address - Fax:707-421-3207
Practice Address - Street 1:1895 WOOLNER AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5807
Practice Address - Country:US
Practice Address - Phone:707-422-3376
Practice Address - Fax:707-422-4315
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SOLANO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-24
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACCS00064FMedicaid