=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518157502
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REDWOOD MIDDLE SCHOOL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/26/2007
-----------------------------------------------------
Last Update Date | 07/26/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3600 OXFORD ST
-----------------------------------------------------
City | NAPA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94558-2735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-253-3415
-----------------------------------------------------
Fax | 707-259-0718
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2310 1ST ST
-----------------------------------------------------
City | NAPA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94559-2239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-253-3415
-----------------------------------------------------
Fax | 707-259-0718
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MICHAEL PEARSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 707-253-3414
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------