Provider Demographics
NPI:1922452747
Name:OHLONE COMMUNITY COLLEGE DISTRICT
Entity Type:Organization
Organization Name:OHLONE COMMUNITY COLLEGE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF STUDENT SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:MINH-HOA
Authorized Official - Middle Name:
Authorized Official - Last Name:TA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-659-6107
Mailing Address - Street 1:43600 MISSION BLVD
Mailing Address - Street 2:STUDENT HEALTH CENTER
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5847
Mailing Address - Country:US
Mailing Address - Phone:510-659-6258
Mailing Address - Fax:
Practice Address - Street 1:43600 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-5847
Practice Address - Country:US
Practice Address - Phone:510-659-6258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHLONE COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-18
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health