NPIMap

Organization Active NPI

Lifeworks of Sonoma County

  • Community/Behavioral Health Agency
  • Santa Rosa, CA
National Provider Identifier
1619295839
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIFEWORKS OF SONOMA COUNTY
Practice address
1260 N Dutton Ave
Ste 105 & Ste 244
Santa Rosa, CA 95401
Phone
(707) 568-2300
Fax
(707) 568-2304
NPI assigned
May 12, 2010
Last updated
Sep 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Authorized official

Name
Mrs. Michelle Fountain
Title
Executive Director
Phone
(707) 568-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1260 N Dutton Ave
Ste 105 & Ste 244
Santa Rosa, CA 95401

Mailing address

1260 N Dutton Ave
Ste 105 & Ste 244
Santa Rosa, CA 95401-7121
Phone (707) 568-2300

National Provider Directory

National Provider Directory
Tax ID family
Lifeworks14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1260 N Dutton Ave
Ste 105
Santa Rosa, CA 95401
Phone (707) 568-2300

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1619295839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 N DUTTON AVE",
            "address_2": "STE 105 & STE 244",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017121",
            "telephone_number": "707-568-2300",
            "fax_number": "707-568-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 N DUTTON AVE",
            "address_2": "STE 105 & STE 244",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95401",
            "telephone_number": "707-568-2300",
            "fax_number": "707-568-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWORKS OF SONOMA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-12",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "FOUNTAIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-568-2300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.