Provider Demographics
NPI:1316812712
Name:EPIC CALIFORNIA ACADEMY
Entity type:Organization
Organization Name:EPIC CALIFORNIA ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CBO/SENIOR DIRECTOR OF BUSINESS OP
Authorized Official - Prefix:
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-799-3220
Mailing Address - Street 1:100 S ANAHEIM BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-3870
Mailing Address - Country:US
Mailing Address - Phone:657-220-1000
Mailing Address - Fax:
Practice Address - Street 1:100 S ANAHEIM BLVD STE 150
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-3870
Practice Address - Country:US
Practice Address - Phone:657-220-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)