Provider Demographics
NPI:1073639340
Name:MT. DIABLO UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MT. DIABLO UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, STUDENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARGOT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-682-8000
Mailing Address - Street 1:1936 CARLOTTA DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-1358
Mailing Address - Country:US
Mailing Address - Phone:925-682-8000
Mailing Address - Fax:925-680-6731
Practice Address - Street 1:1936 CARLOTTA DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-1358
Practice Address - Country:US
Practice Address - Phone:925-682-8000
Practice Address - Fax:925-680-6731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS0761754Medicaid