Provider Demographics
NPI:1427180835
Name:SAN JUAN UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SAN JUAN UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ENOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-971-7104
Mailing Address - Street 1:3738 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-3054
Mailing Address - Country:US
Mailing Address - Phone:916-971-7104
Mailing Address - Fax:
Practice Address - Street 1:3738 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-3054
Practice Address - Country:US
Practice Address - Phone:916-971-7104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
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
CASS3467447Medicaid