FOUNDATION FOR CALIFORNIA STATE UNIVERSITY, SAN BERNARDINO


Address: 164 W Hospitality Ln, Suite 1a, San Bernardino, CA 92408-3316
Phone: 9093791525

FOUNDATION FOR CALIFORNIA STATE UNIVERSITY, SAN BERNARDINO (NPI# 1982728689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1982728689
Entity Type Organization
Organization Name FOUNDATION FOR CALIFORNIA STATE UNIVERSITY, SAN BERNARDINO
Other Organization Name START PEDIATRIC NEURODEVELOPMENTAL ASSESSMENT AND TREATMENT CENTER
Practice Address 164 W Hospitality Ln
Suite 1a
San Bernardino
CA 92408-3316
Mailing Address 5500 University Parkway
San Bernardino
CA 92407
Practice Telephone 9093791525
Enumeration Date 2007-03-19
Last Update Date 2020-08-22
Authorized Official Name MS. DEBORAH BURNS (INTERIM GENERAL MANAGER)
Authorized Official Telephone 9095373939
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health Agencies

Other Provider/Organization Names

Other Name Type Code
START Pediatric Neurodevelopmental Assessment and Treatment Center Other Name - Individual/Organization

Office Location

Street Address 164 W HOSPITALITY LN
SUITE 1A
City SAN BERNARDINO
State CA
Zip Code 92408-3316

Providers in the same location

NPI Name Taxonomy Address Enumeration
1093846198 Augustine J Amerigo I Chiropractor 164 W Hospitality Ln, Ste 110, San Bernardino, CA 92408-3316 2007-03-08
1982016838 Irving M. Feldkamp Dds Dentist 164 W Hospitality Ln, Suite 14, San Bernardino, CA 92408-3316 2014-05-27
1578804696 Tri Star Medical Group & Rehab Physical Medicine & Rehabilitation 164 W Hospitality Ln, Ste. 16, San Bernardino, CA 92408-3316 2013-03-14
1104187103 Family Planning Associates Medical Group,inc. Clinic/Center 164 W Hospitality Ln, 1a, San Bernardino, CA 92408-3316 2012-06-06
1619119328 Rachel L Steward Obstetrics & Gynecology 164 W Hospitality Ln, Suite 1a, San Bernardino, CA 92408-3316 2009-03-26
1356516322 Edith Herrejon Counselor 164 W Hospitality Ln, Ste. 4, San Bernardino, CA 92408-3316 2008-04-29
1699943175 Courtney Ann Wild Case Manager/Care Coordinator 164 W Hospitality Ln, Suite 1-a, San Bernardino, CA 92408-3316 2008-02-18
1902083553 April Faith Valento Counselor 164 W Hospitality Ln, Suite 1a, San Bernardino, CA 92408-3316 2008-01-25
1629254354 Jennifer Marlana Rohrman Counselor 164 W Hospitality Ln, San Bernardino, CA 92408-3316 2008-01-11
1780879791 Ginger R Myren Marriage & Family Therapist 164 W Hospitality Ln, Suite 1-a, San Bernardino, CA 92408-3316 2007-09-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073124681 Valeria Armentilla Cecena Student in an Organized Health Care Education/Training Program 1950 Sunwest Ln., San Bernardino, CA 92408 2020-08-17
1588272066 Horizon Therapy Services Physical Therapist 418 East Vanderbilt, San Bernardino, CA 92408 2020-07-21
1821627639 Bl Anderson Medical Corporation Emergency Medicine 473 E Carnegie Dr., Ste 200, San Bernardino, CA 92408 2020-04-03
1922648104 Infinite Hope Hospice Corp Hospice Care, Community Based 225 W Hospitality Ln Suite 305, San Bernardino, CA 92408 2020-01-15
1689210775 Inland Empire Community Outreach Center Counselor 473 East Carnegie Drive, Suite 200, San Bernardino, CA 92408 2019-11-23
1992347801 Care Marriage and Family Therapists, Inc. Marriage & Family Therapist 1881 Commercenter Drive E, Suite 232, San Bernardino, CA 92408 2019-10-11
1366084360 Theraville Counseling Services, A Licensed Clinical Social Worker Corp Social Worker 155 W Hospitality Ln Ste 245, San Bernardino, CA 92408 2019-10-10
1548730419 Adriana Alcaraz Behavior Technician 473 E Carnegie, Ste 200, San Bernardino, CA 92408 2018-12-04
1811467889 Xavier J Molina-williams Behavior Technician 476 E Carnegie Drive, Ste 200, San Bernardino, CA 92408 2018-12-03
1780153148 Gillian Washington Behavior Technician 473 E Carnegie Dr, Ste 200, Riverside, CA 92408 2018-11-15
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Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
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City SAN BERNARDINO
Zip Code 92408

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Dataset Information

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.

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