Healthcare Provider Details

I. General information

NPI: 1598678229
Provider Name (Legal Business Name): PIVOT CHARTER SCHOOL NORTH BAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 CLEVELAND AVE STE D
SANTA ROSA CA
95403-2761
US

IV. Provider business mailing address

1390 E 9TH ST STE 190
CHICO CA
95928-5966
US

V. Phone/Fax

Practice location:
  • Phone: 707-843-4676
  • Fax:
Mailing address:
  • Phone: 530-636-4362
  • Fax:

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: MS. ELIZABETH JONES
Title or Position: CBO
Credential:
Phone: 530-433-9141