Provider Demographics
NPI:1871796748
Name:COTATI-ROHNERT PARK UNIFIED SCHOOL DISTRICT
Entity type:Organization
Organization Name:COTATI-ROHNERT PARK UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-285-2076
Mailing Address - Street 1:5860 LABATH AVE
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-2041
Mailing Address - Country:US
Mailing Address - Phone:707-285-2076
Mailing Address - Fax:707-792-4505
Practice Address - Street 1:5860 LABATH AVE
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2041
Practice Address - Country:US
Practice Address - Phone:707-285-2076
Practice Address - Fax:707-792-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS4973882Medicaid