Healthcare Provider Details

I. General information

NPI: 1912886797
Provider Name (Legal Business Name): PENN VALLEY UNION ELEMENTARY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14804 PLEASANT VALLEY RD
PENN VALLEY CA
95946-9722
US

IV. Provider business mailing address

PO BOX 475
PENN VALLEY CA
95946-0475
US

V. Phone/Fax

Practice location:
  • Phone: 530-432-7311
  • Fax: 530-432-7314
Mailing address:
  • Phone: 530-432-7311
  • Fax: 530-432-7314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CATHRYN L RUSCICA
Title or Position: EXECUTIVE ADMINISTRATIVE ASST.
Credential:
Phone: 530-432-7311