Healthcare Provider Details

I. General information

NPI: 1841100690
Provider Name (Legal Business Name): CINNABAR SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

286 SKILLMAN LN
PETALUMA CA
94952-1226
US

IV. Provider business mailing address

286 SKILLMAN LN
PETALUMA CA
94952-1226
US

V. Phone/Fax

Practice location:
  • Phone: 707-765-4345
  • Fax: 707-765-4345
Mailing address:
  • Phone: 707-765-4345
  • Fax: 707-765-4549

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: MRS. KATIE FOUCHE
Title or Position: CBO
Credential:
Phone: 707-765-4345