Healthcare Provider Details

I. General information

NPI: 1427965904
Provider Name (Legal Business Name): NOVATO CHARTER SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 C ST
NOVATO CA
94949-5060
US

IV. Provider business mailing address

940 C ST
NOVATO CA
94949-5060
US

V. Phone/Fax

Practice location:
  • Phone: 415-883-4254
  • Fax:
Mailing address:
  • Phone:
  • 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: CHRISTOPHER CAPOBIANCO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 415-883-4254