| Sonoma Valley Community Health Center Mobile Van | |
|
19270 Sonoma Highway 12 Sonoma CA 95476-5414 | |
| (707) 939-6070 | |
| (707) 939-6077 |
| Full Name | Sonoma Valley Community Health Center Mobile Van |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 19270 Sonoma Highway 12, Sonoma, California |
| Authorized Official Name and Position | Charyl K Johnson (CEO) |
| Authorized Official Contact | 7079396075 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sonoma Valley Community Health Center Mobile Van 19270 Sonoma Highway 12 Sonoma CA 95476-5414 Ph: (707) 939-6070 | Sonoma Valley Community Health Center Mobile Van 19270 Sonoma Highway 12 Sonoma CA 95476-5414 Ph: (707) 939-6070 |
| NPI Number | 1093854036 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 07/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093854036 | NPI | - | NPPES |
| FHC53855F | Medicaid | CA | |
| HAP53855F | Medicaid | CA | |
| BCP53855F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 110000251 (California) | Primary |
Guy Delorefice M.d. Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 370 Perkins St, Sonoma, CA 95476 Phone: 707-938-1255 Fax: 707-938-2321 | |
Sonoma Family Practice Medical Associates P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 270 Perkins Street, Sonoma, CA 95476 Phone: 707-938-3131 Fax: 707-938-3678 | |
Walter C. Prehn M.d. A Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 181 Andrieux St, Suite 206, Sonoma, CA 95476 Phone: 707-495-7762 Fax: 707-938-7337 | |
Petaluma Valley Internal Medicine Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1250 Broadway, Sonoma, CA 95476 Phone: 707-262-6267 Fax: 707-734-7766 | |
Sonoma Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 670 Third St West, Sonoma, CA 95476 Phone: 707-938-5916 Fax: 707-938-8496 | |
Sound Inpatient Physicians Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 347 Andrieux St, Sonoma, CA 95476 Phone: 707-935-5000 |