NPIMap

Organization Active NPI

San Bernardino County Public Health Dept.

  • Pediatric Physical Therapist
  • Yucca Valley, CA
National Provider Identifier
1508944075
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
SAN BERNARDINO COUNTY PUBLIC HEALTH DEPT.
Practice address
3380 Avalon
Yucca Mesa Mtu
Yucca Valley, CA 92286-0042
Phone
(760) 369-6315
Fax
(760) 369-1237
NPI assigned
Nov 1, 2006
Organization subpart
Yes
Parent organization
SAN BERNARDINO COUNTY PUBLIC HEALTH DEPT.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Dr. Ohikhuare Maxwell, M.D.
Title
Health Officer
Phone
(909) 387-6218

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X Primary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X

Addresses

Primary practice location

3380 Avalon
Yucca Mesa Mtu
Yucca Valley, CA 92286-0042

Mailing address

451 E Vanderbilt Way
San Bernardino, CA 92408-3641
Phone (909) 387-6218

Other identifiers 1

IdentifierTypeStateIssuer
CCS00116FOtherCAREHAB CLINIC

Other names 1

  • California Children's Services Other name

National Provider Directory

National Provider Directory
Tax ID family
San Bernardino County D142 organizations share this tax ID, including this one
Part of
San Bernardino County D

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1508944075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 E VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083641",
            "telephone_number": "909-387-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 AVALON",
            "address_2": "YUCCA MESA MTU",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922860042",
            "telephone_number": "760-369-6315",
            "fax_number": "760-369-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN BERNARDINO COUNTY PUBLIC HEALTH DEPT.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN BERNARDINO COUNTY PUBLIC HEALTH DEPT.",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "MAXWELL",
        "authorized_official_first_name": "OHIKHUARE",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "909-387-6218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REHAB CLINIC",
            "identifier": "CCS00116F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Children's Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.