NPIMap

Organization Active NPI

County of San Bernardino

Doing business as Department of Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Bernardino, CA
National Provider Identifier
1194934471
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
ZZZ74743Z Issued in CA
Legal business name
COUNTY OF SAN BERNARDINO
Doing business as
Department of Behavioral Health
Practice address
303 E Vanderbilt Way
San Bernardino, CA 92415-0001
Phone
(909) 388-0801
Fax
(909) 890-0435
NPI assigned
May 22, 2007
Last updated
Aug 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X ZZZ74743Z CA Primary

Addresses

Primary practice location

303 E Vanderbilt Way
San Bernardino, CA 92415-0001

Mailing address

303 E Vanderbilt Way
San Bernardino, CA 92415-0001
Phone (909) 388-0801

Other identifiers 1

IdentifierTypeStateIssuer
3600OtherCADRUG MEDI-CAL

Other names 1

  • DEPARTMENT OF BEHAVIORAL HEALTH Doing business as

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
Lucerne Valley Fire District142 organizations share this tax ID, including this one

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

Locations

850 E Foothill Blvd
Ste A
Rialto, CA 92376
Phone (909) 421-9206

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1194934471",
    "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": "924150001",
            "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": "303 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150001",
            "telephone_number": "909-388-0801",
            "fax_number": "909-890-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SAN BERNARDINO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "ZZZ74743Z",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "3600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEPARTMENT OF BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.