Provider Demographics
NPI:1780712869
Name:VACAVILLE UNIFIED SCHOOL DISTRICT
Entity type:Organization
Organization Name:VACAVILLE UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEREENE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-453-6138
Mailing Address - Street 1:751 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3945
Mailing Address - Country:US
Mailing Address - Phone:707-453-6137
Mailing Address - Fax:707-453-6135
Practice Address - Street 1:751 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3945
Practice Address - Country:US
Practice Address - Phone:707-453-6137
Practice Address - Fax:707-453-6135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS4870573Medicaid