Provider Demographics
NPI:1639271935
Name:COUNTY OF TUOLUMNE
Entity type:Organization
Organization Name:COUNTY OF TUOLUMNE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH & HUMAN SERVICES AGENCY DIRE
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-533-5746
Mailing Address - Street 1:COUNTY OF TUOLUMNE PUBLIC HEALTH
Mailing Address - Street 2:20111 CEDAR ROAD NORTH
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370
Mailing Address - Country:US
Mailing Address - Phone:209-533-7401
Mailing Address - Fax:209-533-7406
Practice Address - Street 1:20111 CEDAR ROAD NORTH
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5939
Practice Address - Country:US
Practice Address - Phone:209-533-7401
Practice Address - Fax:209-533-7406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABQ772AMedicare PIN
CAFLU11117FMedicare PIN