DEPARTMENT OF BEHAVIORAL HEALTH SAN BERNARDINO COUNTY CA NPI 1124237425

NPI Information

NPI: 1124237425
Provider Name: DEPARTMENT OF BEHAVIORAL HEALTH, SAN BERNARDINO COUNTY CA

Doing Business As: VICTORVILLE MULTIDIAGNOSIS CLINIC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
12625 HESPERIA RD
VICTORVILLE, CA
ZIP 92395
Phone: (909) 382-3080
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DEPARTMENT OF BEHAVIORAL HEALTH, SAN BERNARDINO COUNTY CA is a multi-specialty clinic center in Victorville, CA. DEPARTMENT OF BEHAVIORAL HEALTH, SAN BERNARDINO COUNTY CA NPI is 1124237425. The provider is registered as an organization entity type.
The provider Is Doing Business As Victorville Multidiagnosis Clinic.

The provider's business location address is:

12625 HESPERIA RD
VICTORVILLE, CA
ZIP 92395-720
Phone: (909) 382-3080
Fax: (909) 382-3105

The provider's authorized official is Michael J. Day .
The authorized official title is Information Technology Manager and has the following contact phone number (909) 388-0570.

The enumeration date for this NPI number is 5/22/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	ZZZ74743Z	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	36AC	OTHER	CALIFORNIA	MEDI-CAL PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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