Organization
COUNTY OF SAN BERNARDINO
Active
Other names
DEPARTMENT OF BEHAVIORAL HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA OCHOA (CHIEF COMPLIANCE OFFICER)
(909) 388-0882
Entity
Organization
Contact information
Practice address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0001
(909) 388-0801
(909) 890-0435
Mailing address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0001
(909) 388-0801
(909) 890-0435
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
ZZZ74743Z
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3600
DRUG MEDI-CAL
CA
Enumeration date
05/22/2007
Last updated
08/09/2023
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