Provider Demographics
NPI:1619197761
Name:COUNTY OF SAN BERNARDINO
Entity type:Organization
Organization Name:COUNTY OF SAN BERNARDINO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-388-0882
Mailing Address - Street 1:755 E GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-5413
Mailing Address - Country:US
Mailing Address - Phone:909-387-7792
Mailing Address - Fax:909-387-7177
Practice Address - Street 1:755 E GILBERT ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-5413
Practice Address - Country:US
Practice Address - Phone:909-387-7792
Practice Address - Fax:909-387-7177
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DPARTMENT OF BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-30
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health