NPIMap

Organization Active NPI

Family Service Agency of Fontana

  • Community/Behavioral Health Agency
  • San Bernardino, CA
National Provider Identifier
1194971820
Registry record updated Jan 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY SERVICE AGENCY OF FONTANA
Practice address
1661 N E St
San Bernardino, CA 92405-4405
Phone
(909) 822-3533
Fax
(909) 822-3050
NPI assigned
Aug 13, 2008
Last updated
Jan 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2013

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

Authorized official

Name
Ms. Christine Laura Edgecombe, MLS/AC
Title
President/Ceo
Phone
(909) 886-6737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1661 N E St
San Bernardino, CA 92405-4405

Mailing address

1669 North E Street
San Bernardino, CA 92405-4405
Phone (909) 886-6737

National Provider Directory

National Provider Directory
Tax ID family
Family Services of San Bernardino7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359072000000",
    "number": "1194971820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 NORTH E STREET",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054405",
            "telephone_number": "909-886-6737",
            "fax_number": "909-881-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 N E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054405",
            "telephone_number": "909-822-3533",
            "fax_number": "909-822-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE AGENCY OF FONTANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2013-01-25",
        "status": "A",
        "authorized_official_last_name": "EDGECOMBE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "LAURA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "909-886-6737",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MLS/AC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 25, 2013; 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.