Provider Demographics
NPI:1487772539
Name:DIXON UNIFIED SCHOOLS DISTRICT
Entity type:Organization
Organization Name:DIXON UNIFIED SCHOOLS DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEA COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-678-9533
Mailing Address - Street 1:180 S. FIRST ST.
Mailing Address - Street 2:SUITE 6
Mailing Address - City:DIXON
Mailing Address - State:AR
Mailing Address - Zip Code:95620
Mailing Address - Country:US
Mailing Address - Phone:707-678-9533
Mailing Address - Fax:707-678-0298
Practice Address - Street 1:180 S. FIRST ST.
Practice Address - Street 2:SUITE 6
Practice Address - City:DIXON
Practice Address - State:CA
Practice Address - Zip Code:95620
Practice Address - Country:US
Practice Address - Phone:707-678-9533
Practice Address - Fax:707-678-0298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS4870532Medicaid