Provider Demographics
NPI:1083136899
Name:CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT
Entity Type:Organization
Organization Name:CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT
Other - Org Name:CHABOT COLLEGE, STUDENT HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ROSAFEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ADRIANO-NOGRA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:510-723-7625
Mailing Address - Street 1:25555 HESPERIAN BLVD
Mailing Address - Street 2:BUILDING 2300 ROOM 2315
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-2447
Mailing Address - Country:US
Mailing Address - Phone:510-723-7625
Mailing Address - Fax:510-723-7129
Practice Address - Street 1:25555 HESPERIAN BLVD
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-2447
Practice Address - Country:US
Practice Address - Phone:510-723-7625
Practice Address - Fax:510-723-7129
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No251300000XAgenciesLocal Education Agency (LEA)