Provider Demographics
NPI:1356132146
Name:DA VINCI RISE HIGH
Entity type:Organization
Organization Name:DA VINCI RISE HIGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, SN, PHD
Authorized Official - Phone:310-725-5800
Mailing Address - Street 1:201 N DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-4637
Mailing Address - Country:US
Mailing Address - Phone:310-725-5800
Mailing Address - Fax:
Practice Address - Street 1:13634 CORDARY AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-7409
Practice Address - Country:US
Practice Address - Phone:310-725-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)