Healthcare Provider Details

I. General information

NPI: 1497273692
Provider Name (Legal Business Name): DISCOVERY CHARTER SCHOOL II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 07/21/2022
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

762 SUNSET GLEN DR
SAN JOSE CA
95123-4543
US

IV. Provider business mailing address

762 SUNSET GLEN DR
SAN JOSE CA
95123-4543
US

V. Phone/Fax

Practice location:
  • Phone: 408-300-1358
  • Fax: 408-972-9114
Mailing address:
  • Phone: 408-300-1358
  • Fax: 408-972-9114

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: MICHELE FELT
Title or Position: BUSINESS SERVICES / FISCAL OFFICER
Credential:
Phone: 408-300-1358