Provisional Educational Services Inc

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

PROVISIONAL EDUCATIONAL SERVICES INC

Doing business as

Provisional Accelerated Learning Academy

Practice address

2450 Blake St
San Bernardino, CA 92407-6104

Phone

(909) 887-7002

NPI assigned

Dec 3, 2024

Last updated

Dec 3, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

PROVISIONAL EDUCATIONAL SERVICES INC (PESI)As reported in NPPES

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

Authorized official

Name

Mr. Dwaine Radden Sr.

Title

Chief Executive Officer

Phone

(909) 887-7002

Specialties & licenses 1

Addresses

Other names 1

• Provisional Accelerated Learning Academy Doing business as

Part of

Provisional Educational Services Inc

Locations

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1447066600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 BLAKE ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924076104",
            "telephone_number": "909-887-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 BLAKE ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924076104",
            "telephone_number": "909-887-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISIONAL EDUCATIONAL SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVISIONAL EDUCATIONAL SERVICES INC (PESI)",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "RADDEN",
        "authorized_official_first_name": "DWAINE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "909-887-7002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provisional Accelerated Learning Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Local Education Agency (LEA) in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Local Education Agency (LEA) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.