NPIMap

Organization Active NPI

California State University San Bernardino

  • Student Health Clinic/Center
  • San Bernardino, CA
National Provider Identifier
1730205154
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
CALIFORNIA STATE UNIVERSITY SAN BERNARDINO
Practice address
5500 University Pkwy
Student Health Center
San Bernardino, CA 92407-2318
Phone
(909) 537-3295
Fax
(909) 537-7027
NPI assigned
Mar 21, 2007
Organization subpart
Yes
Parent organization
CALIFORNIA STATE UNIVERSITY SAN BERNARDINOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Beth Jaworski
Title
Executive Director
Phone
(909) 537-3070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

5500 University Pkwy
Student Health Center
San Bernardino, CA 92407-2318

Mailing address

37500 Cook St
Palm Desert, CA 92211-2900
Phone (909) 289-2965

Other practice location 1

37500 Cook St
Palm Desert, CA 92211-2900
Phone (909) 289-2965

Other names 2

  • CSUSB Student Health and Psychological Counseling Center Other name
  • California State University, San Bernardino, Palm Desert Campus Other name

National Provider Directory

National Provider Directory
Tax ID family
California State University San Bernardino Ap2 organizations share this tax ID, including this one
Part of
California State University San Bernardino Ap

Other organizations with this tax ID 1

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

Locations

37500 Cook St
Palm Desert, CA 92211
Phone (760) 799-2219

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1730205154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37500 COOK ST",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922112900",
            "telephone_number": "909-289-2965",
            "fax_number": "909-537-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 UNIVERSITY PKWY",
            "address_2": "STUDENT HEALTH CENTER",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072318",
            "telephone_number": "909-537-3295",
            "fax_number": "909-537-7027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37500 Cook St",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922112900",
            "country_code": "US",
            "telephone_number": "909-289-2965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CALIFORNIA STATE UNIVERSITY SAN BERNARDINO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALIFORNIA STATE UNIVERSITY SAN BERNARDINO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-02-01",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "JAWORSKI",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-537-3070"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSUSB Student Health and Psychological Counseling Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CSUSB Student Health and Psychological Counseling Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "California State University, San Bernardino, Palm Desert Campus",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 1, 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.