Healthcare Provider Details

I. General information

NPI: 1376694893
Provider Name (Legal Business Name): HOLTVILLE USD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 E 6TH ST
HOLTVILLE CA
92250-1450
US

IV. Provider business mailing address

3333 CONCOURS
ONTARIO CA
91764-4875
US

V. Phone/Fax

Practice location:
  • Phone: 760-356-2974
  • Fax:
Mailing address:
  • Phone: 909-944-7798
  • Fax: 909-481-7410

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: PATRICIA SALCIDO
Title or Position: SUPERINTENDENT
Credential:
Phone: 760-356-2974