Healthcare Provider Details

I. General information

NPI: 1437012234
Provider Name (Legal Business Name): EJE ELEMENTARY ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 S JOHNSON AVE
EL CAJON CA
92020-5811
US

IV. Provider business mailing address

851 S JOHNSON AVE
EL CAJON CA
92020-5811
US

V. Phone/Fax

Practice location:
  • Phone: 619-401-4150
  • Fax:
Mailing address:
  • Phone: 619-401-4150
  • 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: JUAN SAMANIEGO
Title or Position: COMMUNITY SCHOOL COORDINATOR
Credential:
Phone: 619-402-5764