Kids First Foundation of San Bernardino

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KIDS FIRST FOUNDATION OF SAN BERNARDINO

Practice address

2155 Chicago Ave Ste 203
Riverside, CA 92507-2209

Phone

(951) 990-9798

NPI assigned

Apr 8, 2024

Last updated

Apr 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenae S Holtz, LMFT

Title

President

Phone

(760) 596-7615

Specialties & licenses 3

Addresses

Other names 1

• Kids First Foundation Other name

Locations

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.

• Sherilyn D Wadsworth, PPS

  • School Counselor
  • Cave Creek, AZ
  • NPI 1891391561
  NPD

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1518710086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22099 US HIGHWAY 18 UNIT 411",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923078417",
            "telephone_number": "951-990-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 CHICAGO AVE STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072209",
            "telephone_number": "951-990-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS FIRST FOUNDATION OF SAN BERNARDINO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "HOLTZ",
        "authorized_official_first_name": "JENAE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-596-7615",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids First Foundation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rebekah Kibbe, NP
• Meaza Z Kidane, PA-C
• Kids Court and Counseling Center
• Kids First Foundation
• Kids First Foundation
• Neisha Kiefer, CADC-CAS
• Bret Kilker, M.D.
• Jin Seon Kim Paglingayen, M.D.
• Bruce Y. Kim, MD
• Byung Chan Kim, L.AC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Riverside, CA
• Providers in Riverside, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.