MEDICARE: SAN DIEGO UNIFIED 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1205012937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN DIEGO UNIFIED SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	5816 ALLEGHANY STREET B18
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92139
Country	:	US
Telephone Number	:	619-344-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	5816 ALLEGHANY ST # B18
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92139-1712
Country	:	US
Telephone Number	:	619-344-5200
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH ADMIN AIDE
Name	:	MRS. JAMIE SCHAUBEL
Credential	:
Telephone Number	:	858-573-2227

Provider Enumeration Date	:	01/11/2008
Last Update Date	:	10/11/2017

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