Healthcare Provider Details

I. General information

NPI: 1225656846
Provider Name (Legal Business Name): MT. DIABLO UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 PACIFICA AVE
BAY POINT CA
94565-2904
US

IV. Provider business mailing address

1936 CARLOTTA DR
CONCORD CA
94519-1358
US

V. Phone/Fax

Practice location:
  • Phone: 925-458-3216
  • Fax:
Mailing address:
  • Phone: 925-682-8000
  • 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: JESSICA POZOS
Title or Position: SPECIAL EDUCATION ADMINISTRATOR
Credential:
Phone: 925-682-8000