Provider Demographics
NPI:1780008839
Name:RIVERSIDE CITY COLLEGE
Entity Type:Organization
Organization Name:RIVERSIDE CITY COLLEGE
Other - Org Name:STUDENT HEALTH AND PSYCHOLOGICAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE VICE CHANCELLOR, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-222-8789
Mailing Address - Street 1:4800 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-1299
Mailing Address - Country:US
Mailing Address - Phone:951-222-8151
Mailing Address - Fax:
Practice Address - Street 1:4800 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-1299
Practice Address - Country:US
Practice Address - Phone:951-222-8151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERSIDE COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-10
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health