Healthcare Provider Details

I. General information

NPI: 1003623349
Provider Name (Legal Business Name): MODOC COUNTY JOINT UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 W 8TH ST
ALTURAS CA
96101-3116
US

IV. Provider business mailing address

MODOC COUNTY OFFICE OF EDUCATION 139 HENDERSON STREET
ALTURAS CA
96101
US

V. Phone/Fax

Practice location:
  • Phone: 530-233-7101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: ALISHA ROMESHA
Title or Position: DIRECTOR MH SUPPORT SERVICES
Credential: LCSW
Phone: 530-233-7101