NPIMap

Organization Active NPI

Sac Health System

Doing business as SAC Barstow 102

  • Federally Qualified Health Center (FQHC)
  • Barstow, CA
National Provider Identifier
1063280642
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SAC HEALTH SYSTEM
Doing business as
SAC Barstow 102
Practice address
801 E Mountain View St # 102
Barstow, CA 92311-3053
Phone
(909) 382-7100
Fax
(909) 382-7101
NPI assigned
Dec 13, 2023
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SAC HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tasha Amick
Title
Director of Billing
Phone
(909) 219-8665

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU

Addresses

Primary practice location

801 E Mountain View St # 102
Barstow, CA 92311-3053

Mailing address

250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100

Other names 1

  • SAC Barstow 102 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sac Health System Norto18 organizations share this tax ID, including this one
Part of
Sac Health System Norto

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

801 E Mountain View St
Ste 102
Barstow, CA 92311

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1063280642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S G ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103320",
            "telephone_number": "909-382-7100",
            "fax_number": "909-382-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E MOUNTAIN VIEW ST # 102",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113053",
            "telephone_number": "909-382-7100",
            "fax_number": "909-382-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAC HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAC HEALTH SYSTEM",
        "enumeration_date": "2023-12-13",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "AMICK",
        "authorized_official_first_name": "TASHA",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "909-219-8665"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAC Barstow 102",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Barstow, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.