| Organization Name: | MARTIN LUTHER KING, JR TECHNOLOGY ACADEMY |
| NPI Number: | 1063790459 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANNY WILLIAMS (PRINCIPAL) |
| Mailing Address: | 3051 Fairfield St Sacramento |
| State: | CA US |
| Postal Code: | 958151132 |
| Phone Number: | 9165663490 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2011 |
| NPI Last Update Date: | 08/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |