Healthcare Provider Details

I. General information

NPI: 1730305293
Provider Name (Legal Business Name): SAN BERNARDINO CITY UNIFIED SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 W HIGHLAND AVE
SAN BERNARDINO CA
92411-1235
US

IV. Provider business mailing address

777 N F ST
SAN BERNARDINO CA
92410-3017
US

V. Phone/Fax

Practice location:
  • Phone: 909-880-6802
  • Fax:
Mailing address:
  • Phone: 909-880-6802
  • Fax: 909-880-0852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA WHITEPIPER
Title or Position: DIRECTOR , SCHOOL LINKED SERVICES
Credential:
Phone: 909-880-6701