Provider Demographics
NPI:1932589207
Name:SOLANO CONNECT, LLC
Entity Type:Organization
Organization Name:SOLANO CONNECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-999-0306
Mailing Address - Street 1:479 MASON ST STE 317F
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4592
Mailing Address - Country:US
Mailing Address - Phone:707-999-0306
Mailing Address - Fax:707-724-8264
Practice Address - Street 1:479 MASON ST STE 317F
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4592
Practice Address - Country:US
Practice Address - Phone:707-999-0306
Practice Address - Fax:707-724-8264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA027135305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service