Provider Demographics
NPI:1568595932
Name:SAN CARLOS U. S. D. # 20
Entity Type:Organization
Organization Name:SAN CARLOS U. S. D. # 20
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEIDRE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DERHAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-475-2315
Mailing Address - Street 1:SAN CARLOS AVE.
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:AZ
Mailing Address - Zip Code:85550
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SAN CARLOS AVE
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:AZ
Practice Address - Zip Code:85550
Practice Address - Country:US
Practice Address - Phone:028-475-2315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)