Provider Demographics
NPI:1710731658
Name:LAKE COUNTY OFFICE OF EDUCATION
Entity Type:Organization
Organization Name:LAKE COUNTY OFFICE OF EDUCATION
Other - Org Name:CLEAR LAKE HIGH SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT FISCAL
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-262-4100
Mailing Address - Street 1:1152 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAKEPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95453-5517
Mailing Address - Country:US
Mailing Address - Phone:707-262-4100
Mailing Address - Fax:707-263-0197
Practice Address - Street 1:350 LANGE ST
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-3247
Practice Address - Country:US
Practice Address - Phone:707-262-3010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAKE COUNTY OFFICE OF EDUCATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-16
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)