Healthcare Provider Details

I. General information

NPI: 1659275824
Provider Name (Legal Business Name): EMPIRE SPRINGS CHARTER SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27740 JEFFERSON AVE
TEMECULA CA
92590-2638
US

IV. Provider business mailing address

27740 JEFFERSON AVE
TEMECULA CA
92590-2638
US

V. Phone/Fax

Practice location:
  • Phone: 951-252-8800
  • Fax:
Mailing address:
  • Phone: 951-252-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TREVOR JOHNSON
Title or Position: SENIOR DIRECTOR OF BUSINESS
Credential:
Phone: 951-350-4328