Basic Information
| Provider Information | |||||||||
| NPI: | 1639395346 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANTA ANA UNIFIED SCHOOL DISTRICT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1601 E CHESTNUT AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927016322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145585501 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1601 E CHESTNUT AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927016322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145585501 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | TRIGG | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
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| AuthorizedOfficialTitleorPosition: | ASSOCIATE SUPT OF BUSINESS SVCS | ||||||||
| AuthorizedOfficialTelephone: | 7145585826 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251300000X | Y | Agencies | Local Education Agency (LEA) |
ID Information
| ID | Type | State | Issuer | Description | SS3066670 | 05 | CA | MEDICAID |