NPIMap

Organization Active NPI

California Baptist University

  • Student Health Clinic/Center
  • Riverside, CA
National Provider Identifier
1184909947
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
CALIFORNIA BAPTIST UNIVERSITY
Practice address
2900 Adams St Ste C10
Riverside, CA 92504-7915
Phone
(951) 552-8137
NPI assigned
Oct 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Authorized official

Name
Dr. Timothy A SisemoreNPI 1821074832
Title
Clinic Director
Phone
(951) 552-8137

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

2900 Adams St Ste C10
Riverside, CA 92504-7915

Mailing address

2900 Adams St Ste C10
Riverside, CA 92504-7915
Phone (423) 316-2305

National Provider Directory

National Provider Directory
Tax ID family
California Baptist University2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2900 Adams St
Ste C10
Riverside, CA 92504
Phone (951) 552-8137

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1184909947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 ADAMS ST STE C10",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925047915",
            "telephone_number": "423-316-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 ADAMS ST STE C10",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925047915",
            "telephone_number": "951-552-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA BAPTIST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "SISEMORE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "951-552-8137",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.