Organization
COUNTY OF SAN BERNARDINO
Active
Parent organization
DEPARTMENTOF BEHAVIORAL HEALTH
Other names
One Stop Tay Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEPARTMENTOF BEHAVIORAL HEALTH
Authorized official
ERICA OCHOA (CHIEF COMPLIANCE OFFICER)
(909) 388-0882
Entity
Organization
Contact information
Practice address
780 E GILBERT ST, SAN BERNARDINO, CA 92415
(909) 387-7194
Mailing address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0026
(909) 388-0801
(909) 890-0435
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
ZZZ74743Z
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36DD
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
06/21/2007
Last updated
09/07/2022
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