Provider Demographics
NPI:1750813663
Name:YOSEMITE COMMUNITY COLLEGE DISTRICT
Entity type:Organization
Organization Name:YOSEMITE COMMUNITY COLLEGE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE CHANCELLOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-575-6351
Mailing Address - Street 1:435 COLLEGE AVE
Mailing Address - Street 2:HEALTH SERVICES
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-5808
Mailing Address - Country:US
Mailing Address - Phone:209-575-6550
Mailing Address - Fax:
Practice Address - Street 1:435 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5808
Practice Address - Country:US
Practice Address - Phone:209-575-6550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOSEMITE COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-30
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health