MEDICARE: MT. DIABLO 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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1801575055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MT. DIABLO UNIFIED SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	1371 DETROIT AVE
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94520-3521
Country	:	US
Telephone Number	:	925-685-8760
Fax Number	:

Provider Business Practice Location Address
First Line	:	1371 DETROIT AVE
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94520-3521
Country	:	US
Telephone Number	:	925-685-8760
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT DIRECTOR, SPECIAL ED
Name	:	JESSICA POZOS
Credential	:
Telephone Number	:	925-682-8000

Provider Enumeration Date	:	07/14/2023
Last Update Date	:	07/14/2023

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