=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841475464
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TUOLUMNE COUNTY SUPERINTENDENT OF SCHOOLS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/02/2008
-----------------------------------------------------
Last Update Date | 01/02/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 175 FAIRVIEW LN
-----------------------------------------------------
City | SONORA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95370-4809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-536-2000
-----------------------------------------------------
Fax | 209-536-2003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 175 FAIRVIEW LN
-----------------------------------------------------
City | SONORA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95370-4809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-536-2000
-----------------------------------------------------
Fax | 209-536-2003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SUPERINTENDENT
-----------------------------------------------------
Name | MR. JOSEPH A SILVA JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 209-536-2000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number | SS5510553
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------