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NPI Code Detail

MEDICARE: COUNTY OF RIVERSIDE

MEDICARE: COUNTY OF RIVERSIDE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1750225876
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTY OF RIVERSIDE
Provider Business Mailing Address
First Line : 7888 MISSION GROVE PKWY S STE 120
Second Line :
City : RIVERSIDE
State : CA
Zip : 92508-5064
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12125 DAY ST STE U205A
Second Line :
City : MORENO VALLEY
State : CA
Zip : 92557-6703
Country : US
Telephone Number : 951-867-3900
Fax Number :
Authorized Official
Title or Position : CEO
Name : JENNIFER LYNN CRUIKSHANK
Credential :
Telephone Number : 951-486-4135
Provider Enumeration Date : 04/17/2026
Last Update Date : 04/17/2026

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Directions to “COUNTY OF RIVERSIDE ” Practice Location

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