Sozo Recovery Residence

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SOZO RECOVERY RESIDENCE

Practice address

2768 N. Genevieve St
San Bernardino, CA 92405-3516

Phone

(951) 835-1253

NPI assigned

Jul 22, 2025

Organization subpart

No

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

Authorized official

Name

Jeanna Nicole Marquecho Shaw

Title

Director

Phone

(951) 836-1253

Specialties & licenses 6

Addresses

Other names 1

• Sozo House Doing business as

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

{
    "created_epoch": "1753142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1265314157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2768 N. GENEVIEVE ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92405",
            "telephone_number": "951-836-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2768 N. GENEVIEVE ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053516",
            "telephone_number": "951-835-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOZO RECOVERY RESIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "MARQUECHO SHAW",
        "authorized_official_first_name": "JEANNA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "951-836-1253"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sozo House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern California Emergency Medicine
• Southland Anesthesia Consultants Inc
• Southland Cardiology Medical Group
• Southland Dental Group Antoine Sourialle DDS Inc
• Bryan Lee Sowell, M.D.
• Spark Link LLC
• Stacy Darnell Sparks
• Shelby Speaks
• Spectrum Medical and Equipment Supply
• Tiffani Angelica Webb Speicher, NP-BC

• Substance Abuse Rehabilitation Facility in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.