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General NPI Number Information
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NPI Number | 1104183763
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Entity Type | Organization
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Legal Business Name | SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOLS
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 1812 W PARK AVE
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City | REDLANDS
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State | CA
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Zip | 92373-8014
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Country | US
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Telephone | 909-793-0535
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 S SUNWEST LN STE 300
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3225
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Country | US
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Telephone | 909-387-8515
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Fax |
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Authorized Official
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Title or Position | DIRECTOR STUDENT SERVICES
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Name | MARY LAIHEE
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Credential |
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Telephone | 909-387-8515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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