Provider Demographics
NPI:1831466226
Name:CALIFORNIA VIRTUAL ACADEMIES
Entity type:Organization
Organization Name:CALIFORNIA VIRTUAL ACADEMIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCH INTERN
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-735-9723
Mailing Address - Street 1:2360 SHASTA WAY STE A
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5866 MARSHALL ST APT A
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-2616
Practice Address - Country:US
Practice Address - Phone:510-735-9723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)