MEDICARE: ROSELAND SCHOOL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1164810107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSELAND SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	1934 BIWANA DR
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95407-7433
Country	:	US
Telephone Number	:	707-545-0102
Fax Number	:	707-545-5096

Provider Business Practice Location Address
First Line	:	1934 BIWANA DR
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95407-7433
Country	:	US
Telephone Number	:	707-545-0102
Fax Number	:	707-545-5096

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MRS. AMY JONES-KERR
Credential	:
Telephone Number	:	707-545-0102

Provider Enumeration Date	:	12/29/2014
Last Update Date	:	12/29/2014

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Directions to “ROSELAND SCHOOL DISTRICT ” Practice Location

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