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Organization
PLACERVILLE UESD
Active
Organization
PLACERVILLE UESD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NORDQUIST (INTERIM SUPERINTENDENT)
(530) 622-3370
Entity
Organization
Contact information
Practice address
1032 THOMPSON WAY, PLACERVILLE, CA 95667-5713
(530) 622-3370
Mailing address
2777 DEL MONTE ST, WEST SACRAMENTO, CA 95691-3811
(916) 375-1707
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09-61952
MEDI-CAL
CA
Enumeration date
01/02/2007
Last updated
08/22/2020
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