Provider Demographics
NPI:1912097619
Name:SAN BENITO COUNTY HEALTH & HUMAN SERVICES AGENCY/PUBLIC HEALTH
Entity Type:Organization
Organization Name:SAN BENITO COUNTY HEALTH & HUMAN SERVICES AGENCY/PUBLIC HEALTH
Other - Org Name:SAN BENITO COUNTY PUBLIC HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:RYDINGSWORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-636-4180
Mailing Address - Street 1:1111 SAN FELIPE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-2814
Mailing Address - Country:US
Mailing Address - Phone:831-637-5367
Mailing Address - Fax:
Practice Address - Street 1:439 4TH ST
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-3801
Practice Address - Country:US
Practice Address - Phone:831-637-5367
Practice Address - Fax:831-637-9073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare