Provider Demographics
NPI:1073927877
Name:SOUTH ORANGE COUNTY COMMUNITY COLLEGE DISTRICT
Entity Type:Organization
Organization Name:SOUTH ORANGE COUNTY COMMUNITY COLLEGE DISTRICT
Other - Org Name:IRVINE VALLEY COLLEGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR HEALTH,WELLNESS,VET CENTER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-451-5273
Mailing Address - Street 1:5500 IRVINE CENTER DR
Mailing Address - Street 2:STUDENT HEATLH, WELLNESS & VETERANS CENTER - SSC 150
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-0301
Mailing Address - Country:US
Mailing Address - Phone:949-451-5221
Mailing Address - Fax:949-451-5393
Practice Address - Street 1:5500 IRVINE CENTER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0301
Practice Address - Country:US
Practice Address - Phone:949-451-5221
Practice Address - Fax:949-451-5393
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH ORANGE COUNTY COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-19
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health