Provider Demographics
NPI:1881441277
Name:COMMON GOOD COMMUNITY
Entity type:Organization
Organization Name:COMMON GOOD COMMUNITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HONIG
Authorized Official - Suffix:
Authorized Official - Credentials:CHW CERTIFICATE
Authorized Official - Phone:530-231-4413
Mailing Address - Street 1:412 C ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4127
Mailing Address - Country:US
Mailing Address - Phone:530-231-4413
Mailing Address - Fax:
Practice Address - Street 1:412 C ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4127
Practice Address - Country:US
Practice Address - Phone:530-276-8474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty