Provider Demographics
NPI:1710196886
Name:HUNTINGTON BEACH UNION HIGH SCHOOL DISTRICT
Entity Type:Organization
Organization Name:HUNTINGTON BEACH UNION HIGH SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL PERSONNEL SERVICE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-903-7000
Mailing Address - Street 1:5832 BOLSA AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-1115
Mailing Address - Country:US
Mailing Address - Phone:714-903-7000
Mailing Address - Fax:714-372-8102
Practice Address - Street 1:5832 BOLSA AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1115
Practice Address - Country:US
Practice Address - Phone:714-903-7000
Practice Address - Fax:714-372-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
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
CASS3066548Medicaid