Healthcare Provider Details

I. General information

NPI: 1376455097
Provider Name (Legal Business Name): MONTGOMERY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18620 FORT ROSS ROAD
CAZADERO CA
95421
US

IV. Provider business mailing address

PO BOX 286
CAZADERO CA
95421-0286
US

V. Phone/Fax

Practice location:
  • Phone: 707-632-5221
  • Fax:
Mailing address:
  • Phone: 707-632-5221
  • 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: TERESA RAEF
Title or Position: SUPERINTENDENT
Credential:
Phone: 707-632-5221