Provider Demographics
NPI:1104342393
Name:YOSEMITE COMMUNITY COLLEGE DISTRICT
Entity type:Organization
Organization Name:YOSEMITE COMMUNITY COLLEGE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, ADMIN. SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-588-5112
Mailing Address - Street 1:11600 COLUMBIA COLLEGE DRIVE
Mailing Address - Street 2:PINYON
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370
Mailing Address - Country:US
Mailing Address - Phone:209-588-5204
Mailing Address - Fax:209-588-5240
Practice Address - Street 1:11600 COLUMBIA COLLEGE DR
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-8560
Practice Address - Country:US
Practice Address - Phone:209-588-5204
Practice Address - Fax:209-588-5240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health