Provider Demographics
NPI:1821112954
Name:JEFFERSON UNION HIGH SCHOOL DISTRICT
Entity Type:Organization
Organization Name:JEFFERSON UNION HIGH SCHOOL DISTRICT
Other - Org Name:DALY CITY YOUTH HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:GILLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:650-877-5721
Mailing Address - Street 1:699 SERRAMONTE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4132
Mailing Address - Country:US
Mailing Address - Phone:650-550-7900
Mailing Address - Fax:650-550-7888
Practice Address - Street 1:350 90TH ST., 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015
Practice Address - Country:US
Practice Address - Phone:650-877-5700
Practice Address - Fax:650-877-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)