Healthcare Provider Details

I. General information

NPI: 1922911742
Provider Name (Legal Business Name): BUILDING BRIDGES FOSTER FAMILY AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9645 ARROW RTE STE A
RANCHO CUCAMONGA CA
91730-4554
US

IV. Provider business mailing address

9645 ARROW RTE STE A
RANCHO CUCAMONGA CA
91730-4554
US

V. Phone/Fax

Practice location:
  • Phone: 909-948-5747
  • Fax:
Mailing address:
  • Phone: 909-948-5747
  • Fax: 909-948-5746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT D MATHIAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 626-290-6357