Mt. San Jacinto Community College District

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

MT. SAN JACINTO COMMUNITY COLLEGE DISTRICT

Practice address

1499 N State St
San Jacinto, CA 92583-2399

Phone

(951) 465-8371

NPI assigned

Jun 17, 2024

Organization subpart

Yes

Parent organization

MT. SAN JACINTO COMMUNITY COLLEGE DISTRICTAs reported in NPPES

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

Authorized official

Name

Michael Beckham

Title

Interim VP of Business Services

Phone

(951) 465-7939

Specialties & licenses 2

Addresses

Other names 1

• Mt. San Jacinto College Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Mt San Jacinto Community College District2 organizations share this tax ID, including this one

Part of

Mt San Jacinto Community College District

Other organizations with this tax ID 1

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

• Mt. San Jacinto Community College District

  • Student Health Clinic/Center
  • Menifee, CA
  • NPI 1700620127
  NPD tax ID

Locations

Practitioners 1

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

• David Lawrence Brunken, ATC

  • Athletic Trainer
  • San Jacinto, CA
  • NPI 1568428308
  NPD (past)

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1205679339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 N STATE ST",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925832399",
            "telephone_number": "951-465-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 N STATE ST",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925832399",
            "telephone_number": "951-465-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. SAN JACINTO COMMUNITY COLLEGE DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MT. SAN JACINTO COMMUNITY COLLEGE DISTRICT",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "BECKHAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "INTERIM VP OF BUSINESS SERVICES",
        "authorized_official_telephone_number": "951-465-7939"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt. San Jacinto College",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Tybring Morningstar, LCSW
• Donna Mosley
• Mehran Motamed, M,D
• Vernon Arnold Motschman, CADCII
• Linda Christine Moya
• Mariah Mu'Min
• Cesar Munoz
• Ashlee Murray
• Aubry Murray, LVN
• Kasara Eileen Myrvold, RADT

• Student Health Clinic/Center in San Jacinto, CA
• Providers in San Jacinto, CA by specialty
• Student Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.