Provider Demographics
NPI:1356978720
Name:SONOMA IN-HOME AIDES, LLC
Entity type:Organization
Organization Name:SONOMA IN-HOME AIDES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNYUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-548-9552
Mailing Address - Street 1:4226 MOUNT TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-6220
Mailing Address - Country:US
Mailing Address - Phone:707-548-9552
Mailing Address - Fax:
Practice Address - Street 1:4226 MOUNT TAYLOR DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-6220
Practice Address - Country:US
Practice Address - Phone:707-548-9552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA494700033OtherSTATE LICENSE- HOME CARE ORGANIZATION NUMBER