Organization
COUNTY OF RIVERSIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN CRUIKSHANK (CFO)
(951) 486-4135
Entity
Organization
Contact information
Practice address
83912 AVENUE 45, INDIO, CA 92201-7351
(760) 863-8455
Mailing address
4095 COUNTY CIRCLE DR, RIVERSIDE, CA 92503-3410
(951) 358-6900
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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