SONOMA VALLEY COMMUNITY HEALTH CENTER MOBILE VAN – NPI #1093854036
Clinic/Center

SONOMA VALLEY COMMUNITY HEALTH CENTER MOBILE VAN is an AHC clinic located in SONOMA, CA. NPPES has assigned the NPI number 1093854036 to SONOMA VALLEY COMMUNITY HEALTH CENTER MOBILE VAN on February 06, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SONOMA VALLEY COMMUNITY HEALTH CENTER MOBILE VAN” is a dba name, the actual legal business name for this organization is SONOMA VALLEY COMMUNITY HEALTH CENTER. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 12 years ago on Jul 03, 2014. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SONOMA VALLEY COMMUNITY HEALTH CENTER MOBILE VAN below.

NPI Profile for
SONOMA VALLEY COMMUNITY HEALTH CENTER

NPI Number
1093854036
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SONOMA VALLEY COMMUNITY HEALTH CENTER
Doing Business As (dba): SONOMA VALLEY COMMUNITY HEALTH CENTER MOBILE VAN
Primary location
19270 SONOMA HIGHWAY 12
SONOMA, CA 95476-5414
Phone: (707) 939-6070 Fax: (707) 939-6077
Mailing address
Same as primary location
Organization Subpart
Yes - SONOMA VALLEY COMMUNITY HEALTH CENTER MOBILE VAN is subpart of another organization.
Authorized Official
CHARYL JOHNSON
CEO
Phone: (707) 939-6075
Updated
Identifiers

Identifiers for SONOMA VALLEY COMMUNITY HEALTH CENTER MOBILE VAN

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDCAHAP53855F
MEDICAIDCABCP53855F
MEDICAIDCAFHC53855F
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)		 CA 110000251

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.