Healthcare Provider Details

I. General information

NPI: 1427250893
Provider Name (Legal Business Name): CENTRAL UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 N POLK AVE
FRESNO CA
93722-5334
US

IV. Provider business mailing address

4605 N POLK AVE
FRESNO CA
93722-5334
US

V. Phone/Fax

Practice location:
  • Phone: 559-274-4700
  • Fax: 559-271-7211
Mailing address:
  • Phone: 559-274-4700
  • Fax: 559-271-7211

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: MS. VALERIE JOHNSON
Title or Position: DIR. SPECIAL EDUCATION
Credential: M.A.
Phone: 559-274-4700