NPIMap

Organization Active NPI

Martin Luther King, Jr Technology Academy

  • Community/Behavioral Health Agency
  • Sacramento, CA
National Provider Identifier
1063790459
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MARTIN LUTHER KING, JR TECHNOLOGY ACADEMY
Practice address
3051 Fairfield St
Sacramento, CA 95815-1132
Phone
(916) 566-3490
NPI assigned
Aug 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Danny Williams, TEACHER
Title
Principal
Phone
(916) 566-3490

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X

Addresses

Primary practice location

3051 Fairfield St
Sacramento, CA 95815-1132

Mailing address

3051 Fairfield St
Sacramento, CA 95815-1132
Phone (916) 566-3490

National Provider Directory

National Provider Directory
Tax ID family
Twin Rivers Unified School District3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1063790459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 FAIRFIELD ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958151132",
            "telephone_number": "916-566-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 FAIRFIELD ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958151132",
            "telephone_number": "916-566-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN LUTHER KING, JR TECHNOLOGY ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DANNY",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "916-566-3490",
        "authorized_official_credential": "TEACHER"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.