Healthcare Provider Details

I. General information

NPI: 1861037954
Provider Name (Legal Business Name): JURUPA UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3924 RIVERVIEW DR
JURUPA VALLEY CA
92509-6611
US

IV. Provider business mailing address

3924 RIVERVIEW DR
JURUPA VALLEY CA
92509-6611
US

V. Phone/Fax

Practice location:
  • Phone: 951-416-1572
  • Fax:
Mailing address:
  • Phone: 951-360-4175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: JOSE EDUARDO CAMPOS
Title or Position: DIRECTOR
Credential:
Phone: 951-360-4175