Healthcare Provider Details

I. General information

NPI: 1922325646
Provider Name (Legal Business Name): FRUITVALE ELEMENTARY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 04/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7311 ROSEDALE HWY
BAKERSFIELD CA
93308-5738
US

IV. Provider business mailing address

7311 ROSEDALE HWY
BAKERSFIELD CA
93308-5738
US

V. Phone/Fax

Practice location:
  • Phone: 661-589-3830
  • Fax: 661-589-3674
Mailing address:
  • Phone: 661-589-3830
  • Fax: 661-589-3674

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: MR. ROBERT HARTE
Title or Position: CHIEF BUSINESS OFFICER
Credential:
Phone: 661-589-3830