Provider Demographics
NPI:1093841918
Name:MCKINLEYVILLE UNION SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MCKINLEYVILLE UNION SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-839-1549
Mailing Address - Street 1:2275 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-3611
Mailing Address - Country:US
Mailing Address - Phone:707-839-1549
Mailing Address - Fax:707-839-1540
Practice Address - Street 1:2275 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-3611
Practice Address - Country:US
Practice Address - Phone:707-839-1549
Practice Address - Fax:707-839-1540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASS1262950251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS1262950OtherMEDI-CAL PROVIDER NUMBER