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General NPI Number Information
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NPI Number | 1376359539
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Entity Type | Organization
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Legal Business Name | MOUNTAIN ELEMENTARY SCHOOL DISTRICT
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 3042 OLD SAN JOSE RD
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City | SOQUEL
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State | CA
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Zip | 95073-9453
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Country | US
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Telephone | 831-887-8236
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Fax | 831-464-7200
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Provider Business Mailing Address
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Address Line | 3042 OLD SAN JOSE RD
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City | SOQUEL
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State | CA
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Zip | 95073-9453
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Country | US
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Telephone | 831-887-8236
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Fax | 831-464-7200
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MEGAN TRESHAM
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Credential |
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Telephone | 831-475-6812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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