Provider Demographics
NPI:1669802708
Name:COUNTY OF SAN BERNARDINO
Entity type:Organization
Organization Name:COUNTY OF SAN BERNARDINO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PUBLIC GUARDIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MA-PPM
Authorized Official - Phone:909-891-3917
Mailing Address - Street 1:784 E HOSPITALITY LN
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415
Mailing Address - Country:US
Mailing Address - Phone:909-891-3917
Mailing Address - Fax:909-891-3979
Practice Address - Street 1:784 E HOSPITALITY LN
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415
Practice Address - Country:US
Practice Address - Phone:909-891-3917
Practice Address - Fax:909-891-3979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care