Organization Active NPI

San Bernardino County Public Health Dept.

  • Pediatric Physical Therapist
  • Hesperia, CA
National Provider Identifier
1780761981
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
15922 Willow St
Siegrist Mtu
Hesperia, CA 92345-2848
Phone
(760) 244-7999
Fax
(760) 244-4975
NPI assigned
Nov 1, 2006
Organization subpart
No

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. Maxwell Ohikhuare, M.D.
Title
Public Health Officer
Phone
(909) 387-6219

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

15922 Willow St
Siegrist Mtu
Hesperia, CA 92345-2848

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
CCS00090FOtherCAREHAB 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

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

Locations

15922 Willow St
Hesperia, CA 92345
Phone (760) 244-7999

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1780761981",
    "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": "15922 WILLOW ST",
            "address_2": "SIEGRIST MTU",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923452848",
            "telephone_number": "760-244-7999",
            "fax_number": "760-244-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN BERNARDINO COUNTY PUBLIC HEALTH DEPT.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "OHIKHUARE",
        "authorized_official_first_name": "MAXWELL",
        "authorized_official_title_or_position": "PUBLIC HEALTH OFFICER",
        "authorized_official_telephone_number": "909-387-6219",
        "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": "CCS00090F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Children's Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hesperia, 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.