Evergreen Elementary School District

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

EVERGREEN ELEMENTARY SCHOOL DISTRICT

Practice address

3188 Quimby Road
San Jose, CA 95148-3022

Phone

(408) 270-6800

Fax

(408) 274-3894

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Clifton Black, CLEAR ADMINISTRATIVE

Title

District Superintendent

Phone

(408) 270-6814

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1669520326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3188 QUIMBY ROAD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951483022",
            "telephone_number": "408-270-6800",
            "fax_number": "408-274-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3188 QUIMBY ROAD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951483022",
            "telephone_number": "408-270-6800",
            "fax_number": "408-274-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ELEMENTARY SCHOOL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_title_or_position": "DISTRICT SUPERINTENDENT",
        "authorized_official_telephone_number": "408-270-6814",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CLEAR ADMINISTRATIVE"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "43-69435",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Gabriela Everett
• T.C. N/a Everett Jr.
• Wendy Everett
• Evergreen Acupunture Clinic
• Evergreen Cardiology Group, Inc
• Evergreen Eyecare Optometry Inc.
• Evergreen Golden Health Center a Medical Corporation
• Evergreen Hematology Oncology Associates
• Evergreen Hills Medical Group
• Evergreen Medical Associates Inc

• Local Education Agency (LEA) in San Jose, CA
• Providers in San Jose, CA by specialty
• Local Education Agency (LEA) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.