MEDICARE: WEST SONOMA COUNTY UNION HIGH 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	:	1205699188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST SONOMA COUNTY UNION HIGH SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	462 JOHNSON ST
Second Line	:
City	:	SEBASTOPOL
State	:	CA
Zip	:	95472-3431
Country	:	US
Telephone Number	:	707-824-6403
Fax Number	:

Provider Business Practice Location Address
First Line	:	462 JOHNSON ST
Second Line	:
City	:	SEBASTOPOL
State	:	CA
Zip	:	95472-3431
Country	:	US
Telephone Number	:	707-824-6403
Fax Number	:

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. CHRIS MEREDITH
Credential	:
Telephone Number	:	707-824-6403

Provider Enumeration Date	:	02/02/2024
Last Update Date	:	02/13/2026

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Directions to “WEST SONOMA COUNTY UNION HIGH SCHOOL DISTRICT ” Practice Location

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