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General NPI Number Information
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NPI Number | 1164333126
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Entity Type | Organization
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Legal Business Name | MILLER CREEK ELEMENTARY SCHOOL DISTRICT
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Dates
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Enumeration Date | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 380 NOVA ALBION WAY
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3523
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Country | US
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Telephone | 415-874-7564
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Fax |
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Provider Business Mailing Address
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Address Line | 380 NOVA ALBION WAY
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3523
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Country | US
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Telephone | 415-874-7564
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH AND BEHAVIORAL COOR
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Name | MS. CHERYL JACOBS
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Credential | PPS
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Telephone | 415-492-3789
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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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