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General NPI Number Information
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NPI Number | 1669788295
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES SAN BERNARDINO & RIVERSIDE COUNTIES
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 1450 N D ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92405-4739
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Country | US
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Telephone | 909-388-1239
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Fax | 909-384-1130
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Provider Business Mailing Address
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Address Line | 1450 N D ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92405-4739
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Country | US
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Telephone | 909-388-1240
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Fax | 909-285-9273
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Authorized Official
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Title or Position | CEO/EXECUTIVE-VICE-PRESIDENT
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Name | TIMOTHY SEAN NEY
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Credential | MBA
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Telephone | 909-763-5935
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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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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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