1851719157 NPI number — SANTA CLARITA COMMUNITY COLLEGE DISTRICT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851719157 NPI number — SANTA CLARITA COMMUNITY COLLEGE DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANTA CLARITA COMMUNITY COLLEGE DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COLLEGE OF THE CANYONS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851719157
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26455 ROCKWELL CANYON RD
Provider Second Line Business Mailing Address:
S 122
Provider Business Mailing Address City Name:
SANTA CLARITA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91355-1803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-362-3259
Provider Business Mailing Address Fax Number:
661-362-5051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26455 ROCKWELL CANYON RD
Provider Second Line Business Practice Location Address:
S 122
Provider Business Practice Location Address City Name:
SANTA CLARITA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91355-1803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-362-3259
Provider Business Practice Location Address Fax Number:
661-362-5051
Provider Enumeration Date:
04/03/2014

Additional Information

Authorized Official

Authorized Official Last Name:
REEVES
Authorized Official First Name:
COLLEEN
Authorized Official Middle Name:
THERESA
Authorized Official Title or Position:
DIRECTOR, STUDENT HEALTH CENTER
Authorized Official Telephone Number:
661-362-3259

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , with the licence number:  RN568509 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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