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General NPI Number Information
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NPI Number | 1114803327
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Entity Type | Organization
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Legal Business Name | EXTERA PUBLIC SCHOOLS
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 3632 E 5TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90063-3926
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Country | US
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Telephone | 323-261-0059
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Fax |
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Provider Business Mailing Address
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Address Line | 3632 E 5TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90063-3926
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Country | US
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Telephone | 323-261-0059
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | NICOLE DUQUETTE
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Credential |
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Telephone | 323-261-0059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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