Provider Demographics
NPI:1730391053
Name:COUNTY OF SOLANO
Entity type:Organization
Organization Name:COUNTY OF SOLANO
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 MS5 210
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:707-784-8575
Mailing Address - Fax:707-421-3207
Practice Address - Street 1:355 TUOLUMNE ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5700
Practice Address - Country:US
Practice Address - Phone:707-553-5509
Practice Address - Fax:707-553-5658
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SOLANO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-07
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QF0400X, 261QD0000X, 261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC11489FMedicaid
CAZZZ22684ZMedicare PIN
CA551168Medicare Oscar/Certification