NPIMap

Organization Active NPI

County of Sonoma

  • Prison Health Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1104671247
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
COUNTY OF SONOMA
Practice address
2777 Ventura Ave
Santa Rosa, CA 95403-2226
Phone
(707) 565-8831
NPI assigned
Apr 22, 2024
Organization subpart
Yes
Parent organization
COUNTY OF SONOMAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Maureen Nicklas
Title
Administrative Services Officer
Phone
(707) 565-8831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary

Addresses

Primary practice location

2777 Ventura Ave
Santa Rosa, CA 95403-2226

Mailing address

2777 Ventura Ave
Santa Rosa, CA 95403-2226
Phone (707) 565-8831

Other names 1

  • Sonoma County Sheriff's Office Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2143670Wellpath, Sonoma County Jail2777 Ventura Ave, Santa Rosa, CA 95403Certificate of waiverFeb 1, 2028

National Provider Directory

National Provider Directory
Tax ID family
Community Hospital of61 organizations share this tax ID, including this one
Part of
Community Hospital of

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

2777 Ventura Ave
Santa Rosa, CA 95403
Phone (707) 565-1400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1104671247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 VENTURA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032226",
            "telephone_number": "707-565-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 VENTURA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032226",
            "telephone_number": "707-565-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SONOMA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SONOMA",
        "enumeration_date": "2024-04-22",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A",
        "authorized_official_last_name": "NICKLAS",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES OFFICER",
        "authorized_official_telephone_number": "707-565-8831"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sonoma County Sheriff's Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.