NPIMap

Organization Active NPI

Family Service Agency of San Bernardino

  • Community/Behavioral Health Agency
  • Fontana, CA
National Provider Identifier
1518375393
Registry record updated Jul 24, 2014
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
9161 Sierra Ave
Suite 212
Fontana, CA 92335-4729
Phone
(909) 822-3533
Fax
(909) 822-3050
NPI assigned
Jul 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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 Primary

Addresses

Primary practice location

9161 Sierra Ave
Suite 212
Fontana, CA 92335-4729

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 Services of San Bernardino7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

9161 Sierra Ave
Ste 212
Fontana, CA 92335
Phone (909) 822-3533

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1518375393",
    "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": "9161 SIERRA AVE",
            "address_2": "SUITE 212",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354729",
            "telephone_number": "909-822-3533",
            "fax_number": "909-822-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE AGENCY OF SAN BERNARDINO",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2014-07-24",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.