NPIMap

Organization Active NPI

Family Service Agency of San Bernardino

  • Community/Behavioral Health Agency
  • Adelanto, CA
National Provider Identifier
1245680735
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY SERVICE AGENCY OF SAN BERNARDINO
Practice address
11424 Chamberlaine Way
Suite 11-12
Adelanto, CA 92301-2869
Phone
(909) 886-6737
Fax
(909) 881-3871
NPI assigned
Jun 15, 2016
Last updated
Jun 15, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY SERVICE AGENCY OF SAN BERNARDINOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Authorized official

Name
Ms. Patrice J Cormican
Title
Ceo
Phone
(909) 886-6737

Specialties & licenses 1

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

Addresses

Primary practice location

11424 Chamberlaine Way
Suite 11-12
Adelanto, CA 92301-2869

Mailing address

1669 N E St
San Bernardino, CA 92405-4405
Phone (909) 886-6737

National Provider Directory

National Provider Directory
Tax ID family
Family Service Agency O7 organizations share this tax ID, including this one
Part of
Family Service Agency O

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

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.

  • Evelyn Magana
    • Student in an Organized Health Care Education/Training Program
    • Adelanto, CA
    • NPI 1821672247
    NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465948800000",
    "number": "1245680735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 N E ST",
            "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": "11424 CHAMBERLAINE WAY",
            "address_2": "SUITE 11-12",
            "city": "ADELANTO",
            "state": "CA",
            "postal_code": "923012869",
            "telephone_number": "909-886-6737",
            "fax_number": "909-881-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE AGENCY OF SAN BERNARDINO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY SERVICE AGENCY OF SAN BERNARDINO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A",
        "authorized_official_last_name": "CORMICAN",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-886-6737",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adelanto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.