Healthcare Provider Details

I. General information

NPI: 1871773762
Provider Name (Legal Business Name): PLACENTIA YORBA LINDA UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E ORANGETHORPE AVE
PLACENTIA CA
92870-5302
US

IV. Provider business mailing address

1301 E ORANGETHORPE AVE
PLACENTIA CA
92870-5302
US

V. Phone/Fax

Practice location:
  • Phone: 714-986-7000
  • Fax: 714-524-3034
Mailing address:
  • Phone: 714-986-7000
  • Fax: 714-524-3034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number255249
License Number StateCA

VIII. Authorized Official

Name: MRS. TRISHA BRADY
Title or Position: DIRECTOR, S.E.L.P.A.
Credential: MA
Phone: 714-985-8659