Healthcare Provider Details

I. General information

NPI: 1356594832
Provider Name (Legal Business Name): CAMPBELL UNION HIGH SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2008
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3235 UNION AVE
SAN JOSE CA
95124-2009
US

IV. Provider business mailing address

3235 UNION AVE
SAN JOSE CA
95124-2009
US

V. Phone/Fax

Practice location:
  • Phone: 408-371-0960
  • Fax:
Mailing address:
  • Phone: 408-371-0960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. LOIS D SCHOLTZ-GRANT
Title or Position: REGISTERED NURSE
Credential:
Phone: 408-371-0960