NPIMap

Organization Active NPI

County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rialto, CA
National Provider Identifier
1194029066
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COUNTY OF SAN BERNARDINO
Practice address
850 E Foothill Blvd
Rialto, CA 92376-5230
Phone
(909) 873-4488
Fax
(909) 382-3105
NPI assigned
Jan 6, 2011
Organization subpart
Yes
Parent organization
COUNTY OF SAN BERNARDINOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
Erica Ochoa
Title
Chief Compliance Officer
Phone
(909) 388-0882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CA Primary

Addresses

Primary practice location

850 E Foothill Blvd
Rialto, CA 92376-5230

Mailing address

303 E Vanderbilt Way
San Bernardino, CA 92415-0026
Phone (909) 388-0801

Other names 1

  • East Valley Community Crisis Response Team Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209000420 CA Part B Supplier - Clinic/Group Practice 3870499130 Receives reassigned benefits from 233 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Needles, CA; Victorville, CA; San Bernardino, CA; Rialto, CA; Ontario, CA; Hesperia, CA; Fontana, CA; Colton, CA…

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

National Provider Directory

National Provider Directory
Tax ID family
San Bernardino County D142 organizations share this tax ID, including this one
Part of
San Bernardino County D

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 4

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": "1294272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1194029066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150026",
            "telephone_number": "909-388-0801",
            "fax_number": "909-890-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765230",
            "telephone_number": "909-873-4488",
            "fax_number": "909-382-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SAN BERNARDINO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SAN BERNARDINO",
        "enumeration_date": "2011-01-06",
        "last_updated": "2022-09-07",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "OCHOA",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "909-388-0882"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Valley Community Crisis Response Team",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "East Valley Community Crisis Response Team",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.