Organization Active NPI

Kids in Konflict

  • Peer Specialist
  • San Bernardino, CA
National Provider Identifier
1629987318
Registry record updated Sep 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
KIDS IN KONFLICT
Practice address
295 Whipple Mountain Rd
San Bernardino, CA 92410-2109
Phone
(951) 961-5066
NPI assigned
Sep 7, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2026

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

Authorized official

Name
Mr. Lonnie Gardner
Title
Chief Executive Officer
Phone
(951) 961-5066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

295 Whipple Mountain Rd
San Bernardino, CA 92410-2109

Mailing address

295 Whipple Mountain Rd
San Bernardino, CA 92410-2109
Phone (951) 961-5066

NPI Registry JSON

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

{
    "created_epoch": "1788739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788739200000",
    "number": "1629987318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 WHIPPLE MOUNTAIN RD",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924102109",
            "telephone_number": "951-961-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 WHIPPLE MOUNTAIN RD",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924102109",
            "telephone_number": "951-961-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS IN KONFLICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-07",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "951-961-5066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.