NPIMap

Organization Active NPI

Foundation for California State University, San Bernardino

  • Community/Behavioral Health Agency
  • San Bernardino, CA
National Provider Identifier
1982728689
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FOUNDATION FOR CALIFORNIA STATE UNIVERSITY, SAN BERNARDINO
Practice address
164 W Hospitality LN
Suite 1a
San Bernardino, CA 92408-3316
Phone
(909) 379-1525
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Deborah Burns
Title
Interim General Manager
Phone
(909) 537-3939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

164 W Hospitality LN
Suite 1a
San Bernardino, CA 92408-3316

Mailing address

5500 University Parkway
San Bernardino, CA 92407

Other names 1

  • START Pediatric Neurodevelopmental Assessment and Treatment Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Foundation for California State University San Bernardino3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982728689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 UNIVERSITY PARKWAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W HOSPITALITY LN",
            "address_2": "SUITE 1A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083316",
            "telephone_number": "909-379-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION FOR CALIFORNIA STATE UNIVERSITY, SAN BERNARDINO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "INTERIM GENERAL MANAGER",
        "authorized_official_telephone_number": "909-537-3939",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "START Pediatric Neurodevelopmental Assessment and Treatment Center",
            "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 Aug 22, 2020; 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.