Provider Demographics
NPI:1689803769
Name:SAN BERNARDINO COUNTY PROBATION
Entity Type:Organization
Organization Name:SAN BERNARDINO COUNTY PROBATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROBATION OFFICER II
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:EVELYN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-256-4744
Mailing Address - Street 1:175 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-0460
Mailing Address - Country:US
Mailing Address - Phone:760-256-4744
Mailing Address - Fax:
Practice Address - Street 1:301 E. MT. VIEW STREET
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-2840
Practice Address - Country:US
Practice Address - Phone:760-256-4744
Practice Address - Fax:760-256-4761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA171M00000XOtherBARSTOW MENTAL HEALTH COURT