NPIMap

Organization Active NPI

Foundation for California State University San Bernardino

  • Community/Behavioral Health Agency
  • San Bernardino, CA
National Provider Identifier
1225213697
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FOUNDATION FOR CALIFORNIA STATE UNIVERSITY SAN BERNARDINO
Practice address
165 W Hospitality LN
Suite 12
San Bernardino, CA 92408-3334
Phone
(909) 891-1880
Fax
(909) 891-1888
NPI assigned
Jan 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Authorized official

Name
Ms. Deborah Burns
Title
General Manager
Phone
(909) 537-3939

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

165 W Hospitality LN
Suite 12
San Bernardino, CA 92408-3334

Mailing address

5500 University Pkwy
San Bernardino, CA 92407-2318
Phone (909) 537-3939

Other names 1

  • START Pediatric Neurodevelopmental Assessment and Treatment Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Foundation for California State University San Bernardino3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

165 W Hospitality Ln
Ste 12
Sn Bernrdno, CA 92408
Phone (909) 891-1880

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1225213697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 UNIVERSITY PKWY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072318",
            "telephone_number": "909-537-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 W HOSPITALITY LN",
            "address_2": "SUITE 12",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083334",
            "telephone_number": "909-891-1880",
            "fax_number": "909-891-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION FOR CALIFORNIA STATE UNIVERSITY SAN BERNARDINO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "909-537-3939",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "START Pediatric Neurodevelopmental Assessment and Treatment Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 4, 2008; 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.