Provider Demographics
NPI:1437577103
Name:SANTA CLARITA COMMUNITY COLLEGE DISTRICT
Entity Type:Organization
Organization Name:SANTA CLARITA COMMUNITY COLLEGE DISTRICT
Other - Org Name:COLLEGE OF THE CANYONS, STUDENT HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT, STUDENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-259-7800
Mailing Address - Street 1:26455 ROCKWELL CANYON RD
Mailing Address - Street 2:STUDENT CENTER-122
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1803
Mailing Address - Country:US
Mailing Address - Phone:661-362-3259
Mailing Address - Fax:
Practice Address - Street 1:26455 ROCKWELL CANYON RD
Practice Address - Street 2:STUDENT CENTER-122
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-1803
Practice Address - Country:US
Practice Address - Phone:661-362-3259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANTA CLARITA COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-31
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health