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General NPI Number Information
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NPI Number | 1740481613
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Entity Type | Organization
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Legal Business Name | COUNTY OF SAN BERNARDINO
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 18818 US HIGHWAY 18
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City | APPLE VALLEY
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State | CA
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Zip | 92307-2323
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Country | US
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Telephone | 760-995-8868
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Fax | 760-995-8937
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Provider Business Mailing Address
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Address Line | 18818 US HIGHWAY 18
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City | APPLE VALLEY
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State | CA
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Zip | 92307-2323
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Country | US
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Telephone | 760-995-8868
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Fax | 760-995-8937
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | ERICA OCHOA
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Credential |
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Telephone | 909-388-0882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | ZZZ74743Z
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License Number State | CA
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