Healthcare Provider Details

I. General information

NPI: 1760505788
Provider Name (Legal Business Name): COLTON JOINT UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10435 CEDAR AVE
BLOOMINGTON CA
92316-2403
US

IV. Provider business mailing address

1212 VALENCIA DR
COLTON CA
92324-1731
US

V. Phone/Fax

Practice location:
  • Phone: 909-876-4281
  • Fax: 909-876-4080
Mailing address:
  • Phone: 909-580-5000
  • Fax: 909-422-0128

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. CASEY CRIDELICH
Title or Position: ASST. SUPT., BUSINESS SERVICES
Credential:
Phone: 909-580-5000