VICTOR VALLEY COUNSELING CENTER, MENTAL HEALTH COURT (NPI# 1912235573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912235573 |
| Entity Type | Organization |
| Organization Name | VICTOR VALLEY COUNSELING CENTER, MENTAL HEALTH COURT |
| Practice Address |
12625 Hesperia Rd Victorville CA 92395-7720 |
| Mailing Address |
303 E Vanderbilt Way San Bernardino CA 92415-0026 |
| Practice Telephone | 9093823080 |
| Practice Fax Number | 9093823105 |
| Mailing Telephone | 9093880801 |
| Mailing Fax Number | 9098900435 |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2019-06-18 |
| Authorized Official Name | MS. ERICA PORTEOUS (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Telephone | 9093880882 |
| Is Organization Subpart | Y |
| Parent Organization Name | COUNTY OF SAN BERNARDINO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
12625 HESPERIA RD |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-7720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679663181 | Jaidev Madgulkar | Social Worker | 12625 Hesperia Rd, Victorville, CA 92395-7720 | 2006-10-13 |
| 1336765007 | Holly Marie Croteau | Registered Nurse | 12625 Hesperia Rd, Victorville, CA 92395-7720 | 2020-06-18 |
| 1033735881 | Tess Mcclellan | Peer Specialist | 12625 Hesperia Rd, Victorville, CA 92395-7720 | 2020-06-17 |
| 1588287536 | Sandra Martinez | Case Manager/Care Coordinator | 12625 Hesperia Rd, Victorville, CA 92395-7720 | 2020-05-26 |
| 1235764739 | Deborah Courtney-taylor | Case Manager/Care Coordinator | 12625 Hesperia Rd, Victorville, CA 92395-7720 | 2020-03-05 |
| 1205461951 | Rose Arcelia Rosas | Counselor | 12625 Hesperia Rd, Victorville, CA 92395-7720 | 2020-03-03 |
| 1083250690 | Tonii Marie Cardoza | Case Manager/Care Coordinator | 12625 Hesperia Rd, Victorville, CA 92395-7720 | 2019-11-19 |
| 1558918680 | Jennifer Greeno | Counselor | 12625 Hesperia Rd, Victorville, CA 92395-7720 | 2019-08-22 |
| 1972072387 | Sarah Sue Originales | Licensed Vocational Nurse | 12625 Hesperia Rd, Victorville, CA 92395-7720 | 2018-11-14 |
| 1104305879 | Sarah Ann Marroquin | Registered Nurse | 12625 Hesperia Rd, Victorville, CA 92395 | 2018-08-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
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| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912259680 | County of San Bernardino | Clinic/Center | 15480 Ramona Ave, Victorville, CA 92392-2421 | 2012-10-05 |
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| City | VICTORVILLE |
| Zip Code | 92395 |
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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.