1003113663 NPI number — WALNUT VALLEY UNIFIED SCHOOL 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 1003113663 NPI number — WALNUT VALLEY UNIFIED SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WALNUT VALLEY UNIFIED SCHOOL 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:
Provider Other Organization Name Type Code:
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:
1003113663
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
880 S LEMON AVE
Provider Second Line Business Mailing Address:
EDUCATIONAL SERVICES
Provider Business Mailing Address City Name:
WALNUT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91789-2931
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-595-1261
Provider Business Mailing Address Fax Number:
909-839-1212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
880 S LEMON AVE
Provider Second Line Business Practice Location Address:
EDUCATIONAL SERVICES
Provider Business Practice Location Address City Name:
WALNUT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91789-2931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-595-1261
Provider Business Practice Location Address Fax Number:
909-839-1212
Provider Enumeration Date:
02/17/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANNICCHIARICO
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
V.
Authorized Official Title or Position:
ADMINISTRATIVE DIRECTOR
Authorized Official Telephone Number:
909-595-1261

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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