VICTOR COMMUNITY SUPPORT SERVICES, INC. (NPI# 1851670418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851670418 |
| Entity Type | Organization |
| Organization Name | VICTOR COMMUNITY SUPPORT SERVICES, INC. |
| Other Organization Name | VICTOR COMMUNITY SUPPORT SERVICES, CHRIS |
| Practice Address |
1053 N D St San Bernardino CA 92410-3521 |
| Mailing Address |
1360 E Lassen Ave Chico CA 95973-7823 |
| Practice Telephone | 9514365200 |
| Practice Fax Number | 9098849035 |
| Mailing Telephone | 5308930758 |
| Mailing Fax Number | 5308930502 |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2013-08-29 |
| Authorized Official Name | ANGELA R WIECHERT (MANAGER OF FINANCIAL PLANNING) |
| Authorized Official Telephone | 5302301210 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LEGAL ENTITY # | 01042 | 01 |
| Other Name | Type Code |
|---|---|
| Victor Community Support Services, ChRIS | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579628 | Victor Community Support Services, Inc. | Clinic/Center | 302 Cherry Ln Ste 101&201, Manteca, CA 95337-4311 | 2019-10-17 |
| 1780957282 | Victor Community Support Services, Inc. | Clinic/Center | 600 N Arrowhead Ave Ste 300, San Bernardino, CA 92401-1148 | 2012-02-14 |
| 1629240270 | Victor Community Support Services, Inc. | Clinic/Center | 555 N Perris Blvd Bldg A, Perris, CA 92571-2811 | 2008-03-24 |
| 1972689370 | Victor Community Support Services, Inc. | Community/Behavioral Health | 1360 E Lassen Ave, Chico, CA 95973-7823 | 2006-10-27 |
| 1366950784 | Victor Community Support Services, Inc. | Clinic/Center | 1105 E Florida Ave, Hemet, CA 92543-4512 | 2018-01-19 |
| 1922306620 | Victor Community Support Services, Inc. | Community/Behavioral Health | 555 N Perris Blvd, Perris, CA 92571-2811 | 2011-03-03 |
| 1417264185 | Victor Community Support Services, Inc. | Clinic/Center | 3050 Beacon Blvd Ste 103, West Sacramento, CA 95691-3467 | 2010-09-01 |
| 1669703427 | Victor Community Support Services, Inc. | Clinic/Center | 265 San Jacinto River Rd, Suite 106, 107, 201-207, Lake Elsinore, CA 92530 | 2010-01-19 |
| 1831369099 | Victor Community Support Services, Inc. | Clinic/Center | 15400 Cholame Rd, Victorville, CA 92392-2480 | 2008-03-04 |
| 1932251980 | Victor Community Support Services, Inc. | Community/Behavioral Health | 2495 W March Ln, Suite 125, Stockton, CA 95207-8251 | 2007-01-18 |
| Street Address |
1053 N D ST |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92410-3521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831207489 | Richard George Myatt | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2006-08-25 |
| 1679103543 | Tracy Lynn Wainwright | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2020-01-20 |
| 1174165468 | Elva Alejandra Silva | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-10-08 |
| 1477102796 | Kathryn Christensen | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-09-09 |
| 1780232330 | Victor Samuel Ramirez | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-08-27 |
| 1669029039 | Natalie Salas | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-08-21 |
| 1700431459 | Gerson Yestin Bravo | Marriage & Family Therapist | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-08-08 |
| 1689226672 | Altanyce Brown | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-07-10 |
| 1679133235 | Jessica Jimenez | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-06-17 |
| 1922668854 | Beatrice A De La Cerra | Counselor | 1053 N D St, San Bernardino, CA 92410-3521 | 2019-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902303472 | Reina Elora Garcia | Student in an Organized Health Care Education/Training Program | 775 E Base Line St Spc 4, San Bernardino, CA 92410 | 2018-04-10 |
| 1558889881 | Salaunge Lopez | Non-emergency Medical Transport (VAN) | 25942 Baseline St Apt D203, San Bernardino, CA 92410 | 2017-09-07 |
| 1902328578 | Kelly Canady | Counselor | 1100 N. D St., San Bernardino, CA 92410 | 2017-07-14 |
| 1881058592 | Terron Thomas | Contractor | 445 South G, Unit B, San Bernardino, IN 92410 | 2016-04-08 |
| 1982064572 | Zachary Norton-martinez | Specialist/Technologist | 650 Del Rosa Dr, San Bernardino, CA 92410 | 2016-02-25 |
| 1003280934 | Brenda Boyle | Nurse Practitioner | 1455 East 3rd Street, San Bernardino, CA 92410 | 2015-11-16 |
| 1689045197 | Bryan Carter | Physician Assistant | 1455 E 3rd Street, San Bernardino, CA 92410 | 2015-10-09 |
| 1801270137 | Sac Health System | Clinic/Center | 250 South G Street, San Bernardino, CA 92410 | 2015-07-16 |
| 1467852269 | Wilson Dentistry, Inc. | Dentist | 1063 N. D St, San Bernardino, CA 92410 | 2014-08-28 |
| 1629405345 | Terrence John Forrester | Social Worker | 1455 E. 3rd St, San Bernardino, CA 92410 | 2013-09-27 |
| Find all providers in zip 92410 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688892 | Berhe Group Home Inc. | Community/Behavioral Health | 5994 Mckinley Ave, San Bernardino, CA 92404-3530 | 2020-04-16 |
| 1902436744 | Koinonia Foster Homes, Inc. | Community/Behavioral Health | 1881 Business Center Dr Ste 10, San Bernardino, CA 92408-3465 | 2020-01-21 |
| 1750931572 | County of San Bernardino | Community/Behavioral Health | 351 N Mt View Ave San Bernardino Ca 92415, San Bernardino, CA 92415-0001 | 2019-09-13 |
| 1922579598 | Expert Aba Consulting | Community/Behavioral Health | 3975 Modesto Dr, San Bernardino, CA 92404-1946 | 2018-12-07 |
| 1619452547 | County of San Bernardino | Community/Behavioral Health | 900 E Gilbert St Bldg 31, San Bernardino, CA 92415-0911 | 2018-09-26 |
| 1558878819 | Latasha Shenise Jones | Community/Behavioral Health | 2030 E 19th St Apt C, San Bernardino, CA 92404-5800 | 2018-01-08 |
| 1609392729 | Berhe Group Home, Inc. | Community/Behavioral Health | 1604 N Pennsylvania Ave, San Bernardino, CA 92411-1171 | 2017-08-21 |
| 1003331018 | Bianka Elsie Sanchez | Community/Behavioral Health | 7812 Merito Ave, San Bernardino, CA 92410-4631 | 2017-08-10 |
| 1821511908 | Wendy Martinez | Community/Behavioral Health | 5550 University Pkwy, San Bernardino, CA 92407-2318 | 2017-07-20 |
| 1801319124 | Ernesto Alonso | Community/Behavioral Health | 325 W Hospitality Ln Ste 104, San Bernardino, CA 92408-3210 | 2017-07-18 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92410 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.