MEDICARE: CATHOLIC CHARITIES SAN BERNARDINO & RIVERSIDE COUNTIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1669788295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC CHARITIES SAN BERNARDINO & RIVERSIDE COUNTIES

Provider Business Mailing Address
First Line	:	1450 N D ST
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92405-4739
Country	:	US
Telephone Number	:	909-388-1240
Fax Number	:	909-285-9273

Provider Business Practice Location Address
First Line	:	1450 N D ST
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92405-4739
Country	:	US
Telephone Number	:	909-388-1239
Fax Number	:	909-384-1130

Authorized Official
Title or Position	:	CEO/EXECUTIVE-VICE-PRESIDENT
Name	:	TIMOTHY SEAN NEY
Credential	:	MBA
Telephone Number	:	909-763-5935

Provider Enumeration Date	:	08/20/2010
Last Update Date	:	01/21/2026

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Directions to “CATHOLIC CHARITIES SAN BERNARDINO & RIVERSIDE COUNTIES ” Practice Location

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