Provider Demographics
NPI:1902471394
Name:YWCA SONOMA COUNTY
Entity Type:Organization
Organization Name:YWCA SONOMA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNELL
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:707-303-8410
Mailing Address - Street 1:PO BOX 3506
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95402-3506
Mailing Address - Country:US
Mailing Address - Phone:707-303-8410
Mailing Address - Fax:
Practice Address - Street 1:1128 EDWARDS AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-8801
Practice Address - Country:US
Practice Address - Phone:707-303-8410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)