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General NPI Number Information
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NPI Number | 1700748175
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Entity Type | Organization
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Legal Business Name | SAC HEALTH SYSTEM
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 1020 PACIFIC ST STE B
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-6228
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Country | US
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Telephone | 909-382-7100
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Fax | 909-382-7101
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Provider Business Mailing Address
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Address Line | 1003 E BRIER DR
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-2817
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Country | US
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Telephone | 909-382-7100
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Fax | 909-382-7101
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | TASHA AMICK
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Credential |
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Telephone | 909-382-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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