Provider Demographics
NPI:1720598451
Name:PETALUMA CITY SCHOOLS
Entity Type:Organization
Organization Name:PETALUMA CITY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CBO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-778-4621
Mailing Address - Street 1:200 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-2567
Mailing Address - Country:US
Mailing Address - Phone:707-778-4614
Mailing Address - Fax:707-778-5071
Practice Address - Street 1:200 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-2567
Practice Address - Country:US
Practice Address - Phone:707-778-4614
Practice Address - Fax:707-778-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)