Provider Demographics
NPI:1609307925
Name:UNION AVE ELEMENTARY SCHOOL
Entity Type:Organization
Organization Name:UNION AVE ELEMENTARY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TEDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-481-7464
Mailing Address - Street 1:1200 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1908
Mailing Address - Country:US
Mailing Address - Phone:213-481-7464
Mailing Address - Fax:
Practice Address - Street 1:150 S BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2506
Practice Address - Country:US
Practice Address - Phone:213-483-1345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMANECER COMMUNITY COUNSELING SERVICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-27
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)