MEDICARE: THE COTTONWOOD SCHOOL

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)

General Provider Information

NPI Number	:	1659177475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE COTTONWOOD SCHOOL

Provider Business Mailing Address
First Line	:	3921 SANDSTONE DR STE 100
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9343
Country	:	US
Telephone Number	:	530-285-2003
Fax Number	:

Provider Business Practice Location Address
First Line	:	3921 SANDSTONE DR STE 100
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9343
Country	:	US
Telephone Number	:	530-285-2003
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	STACIE IVERY
Credential	:
Telephone Number	:	916-827-0212

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	02/21/2025

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Directions to “THE COTTONWOOD SCHOOL ” Practice Location

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