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General NPI Number Information
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NPI Number | 1932396512
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Entity Type | Organization
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Legal Business Name | STUDENT HEALTH SERVICES
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 3801 W TEMPLE AVE BUILDING #46
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City | POMONA
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State | CA
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Zip | 91768-2557
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Country | US
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Telephone | 909-869-4000
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Fax | 909-869-4561
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Provider Business Mailing Address
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Address Line | 3801 W TEMPLE AVE BUILDING #46
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City | POMONA
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State | CA
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Zip | 91768-2557
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Country | US
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Telephone | 909-869-4000
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Fax | 909-869-4561
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. KAY VIERRA
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Credential | RN
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Telephone | 909-869-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | CA
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