MEDICARE: WEST CONTRA COSTA UNIFIED SCHOOL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07-61796	OTHER	CA	MEDI-CAL

General Provider Information

NPI Number	:	1558418392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST CONTRA COSTA UNIFIED SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	3000 PARKER RD # 20
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94806-2742
Country	:	US
Telephone Number	:	510-307-4630
Fax Number	:	510-724-8829

Provider Business Practice Location Address
First Line	:	3000 PARKER RD # 20
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94806-2742
Country	:	US
Telephone Number	:	510-307-4630
Fax Number	:	510-724-8829

Authorized Official
Title or Position	:	TYPIST CLERK LLL
Name	:	MRS. CHRISTINE DIANE EDWARDS
Credential	:
Telephone Number	:	510-307-4630

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	06/17/2021

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Directions to “WEST CONTRA COSTA UNIFIED SCHOOL DISTRICT ” Practice Location

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