Provider Demographics
NPI:1629260328
Name:ROOSEVELTSCHOOLDISTRICT
Entity Type:Organization
Organization Name:ROOSEVELTSCHOOLDISTRICT
Other - Org Name:SUNLANDSCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARAJ
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZIERDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:602-232-4960
Mailing Address - Street 1:5401 S 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-4015
Mailing Address - Country:US
Mailing Address - Phone:602-232-4960
Mailing Address - Fax:
Practice Address - Street 1:5401 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-4015
Practice Address - Country:US
Practice Address - Phone:602-232-4960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0101YS0200X, 251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty
No251300000XAgenciesLocal Education Agency (LEA)Group - Single Specialty