Healthcare Provider Details

I. General information

NPI: 1689730400
Provider Name (Legal Business Name): SANTA CRUZ CITY ELEMENTARY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 OLD SAN JOSE RD
SOQUEL CA
95073-2213
US

IV. Provider business mailing address

405 OLD SAN JOSE RD
SOQUEL CA
95073-2213
US

V. Phone/Fax

Practice location:
  • Phone: 831-429-3410
  • Fax: 831-429-3450
Mailing address:
  • Phone: 831-429-3410
  • Fax: 831-429-3450

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. MARILYN TORP
Title or Position: DIRECTOR OF SPECIAL EDUCATION
Credential:
Phone: 831-429-3410