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Organization
EVERGREEN ELEMENTARY SCHOOL DISTRICT
Active
Organization
EVERGREEN ELEMENTARY SCHOOL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLIFTON BLACK CLEAR ADMINISTRATIVE (DISTRICT SUPERINTENDENT)
(408) 270-6814
Entity
Organization
Contact information
Practice address
3188 QUIMBY ROAD, SAN JOSE, CA 95148-3022
(408) 270-6800
(408) 274-3894
Mailing address
3188 QUIMBY ROAD, SAN JOSE, CA 95148-3022
(408) 270-6800
(408) 274-3894
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
CA
251300000X
Local Education Agency (LEA)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43-69435
MEDI-CAL
CA
Enumeration date
01/08/2007
Last updated
02/10/2010
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