Healthcare Provider Details

I. General information

NPI: 1952213779
Provider Name (Legal Business Name): SCHOLARSHIP PREP - SOUTH BAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24910 S AVALON BLVD
WILMINGTON CA
90744-1029
US

IV. Provider business mailing address

313 N BIRCH ST STE 103
SANTA ANA CA
92701-5263
US

V. Phone/Fax

Practice location:
  • Phone: 424-251-9957
  • Fax:
Mailing address:
  • Phone: 949-283-6991
  • 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: SARAH SCHOENFELD-NAKAMOTO
Title or Position: CBO
Credential:
Phone: 949-283-6991