Provider Demographics
NPI:1144707043
Name:FREMONT UNION HIGH SCHOOL DISTRICT
Entity type:Organization
Organization Name:FREMONT UNION HIGH SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-256-4628
Mailing Address - Street 1:90 GREAT OAKS BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1314
Mailing Address - Country:US
Mailing Address - Phone:408-281-0708
Mailing Address - Fax:408-281-2659
Practice Address - Street 1:591 W FREMONT AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087
Practice Address - Country:US
Practice Address - Phone:408-281-0708
Practice Address - Fax:408-281-2695
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENT GROUP MINISTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-24
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health