Healthcare Provider Details

I. General information

NPI: 1275780504
Provider Name (Legal Business Name): LOS ANGELES UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 SAN JULIAN ST # 2
LOS ANGELES CA
90015-3142
US

IV. Provider business mailing address

1041 FOOTHILL ST
SOUTH PASADENA CA
91030-1717
US

V. Phone/Fax

Practice location:
  • Phone: 213-765-2800
  • Fax:
Mailing address:
  • Phone: 626-441-0687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number289005
License Number StateCA

VIII. Authorized Official

Name: PATRICIA MARIE WOOD
Title or Position: SCHOOL NURSE PRACTIONER
Credential: RN, CFNP
Phone: 626-298-2909