Blue Heron

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

Organization subpart

No

Name

Donna Becnel, PHD

Title

Superintendent

Phone

(707) 994-6475

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.

• Carle High School

  • Local Education Agency (LEA)
  • Lower Lake, CA
  • NPI 1477982684
  NPD tax ID
• East Lake Elementary

  • Local Education Agency (LEA)
  • Clearlake Oaks, CA
  • NPI 1992134100
  NPD tax ID
• Konocti Unified School District

  • Local Education Agency (LEA)
  • Lower Lake, CA
  • NPI 1649496605
  NPD tax ID

Locations

• Konocti Unified Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 2, 2013.

{
    "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"
        }
    ]
}

• Sara Leann Baslee
• Sherry Bauman
• Melissa Maria Baxter, CADC II
• Erin Bennett, MSN, APRN, FNP-BC
• Arthur William Bikangaga, MD
• Saffron Jacynth Blue
• Jerylyn Bohlender, LCSW
• Robert Bonner, O.D.
• Brandy Coleen Borg
• Daniel Elkins Boucher, MD

• All providers in Clearlake, CA
• Local Education Agency (LEA) in California

• 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.