NPIMap

Organization Active NPI

Blue Heron

  • Local Education Agency (LEA)
  • Clearlake, CA
National Provider Identifier
1376972190
Registry record updated Nov 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
BLUE HERON
Practice address
15850 Dam Road Ext
Clearlake, CA 95422-9359
Phone
(707) 994-6447
NPI assigned
Nov 2, 2013
Last updated
Nov 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2013

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

Authorized official

Name
Donna Becnel, PHD
Title
Superintendent
Phone
(707) 994-6475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X Primary

Addresses

Primary practice location

15850 Dam Road Ext
Clearlake, CA 95422-9359

Mailing address

15850 Dam Road Ext
Clearlake, CA 95422-9359
Phone (707) 994-6447

Other names 1

  • Konocti Unified Other name

National Provider Directory

National Provider Directory
Tax ID family
Blue Heron4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

15850 Dam Road Ext
Clearlake, CA 95422
Phone (707) 994-6447

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1376972190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15850 DAM ROAD EXT",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229359",
            "telephone_number": "707-994-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15850 DAM ROAD EXT",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229359",
            "telephone_number": "707-994-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HERON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "BECNEL",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "707-994-6475",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Konocti Unified",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clearlake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.