Provider Demographics
NPI:1134945991
Name:PACIFIC ELEMENTARY SCHOOL DISTRICT
Entity type:Organization
Organization Name:PACIFIC ELEMENTARY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT/PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-425-7002
Mailing Address - Street 1:PO BOX H
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95017-1007
Mailing Address - Country:US
Mailing Address - Phone:831-425-7002
Mailing Address - Fax:
Practice Address - Street 1:50 OCEAN ST.
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:CA
Practice Address - Zip Code:95017-1107
Practice Address - Country:US
Practice Address - Phone:831-425-7002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty