Provider Demographics
NPI:1134286362
Name:GREENFIELD UNION ELEMENTARY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GREENFIELD UNION ELEMENTARY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUALARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-674-2840
Mailing Address - Street 1:2950 BEACON BLVD STE 50
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-5031
Mailing Address - Country:US
Mailing Address - Phone:916-375-1707
Mailing Address - Fax:
Practice Address - Street 1:493 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:CA
Practice Address - Zip Code:93927-4915
Practice Address - Country:US
Practice Address - Phone:831-674-2840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA27-66035OtherMEDI-CAL