Organization · Type 2 NPI

Mt. San Jacinto Community College District

Student Health Clinic/Center · San Jacinto, CA

NPI number 1205679339 Active

Practice location

1499 N State St
San Jacinto, CA 92583-2399

Specialties and licenses

Taxonomy	Code	License
Local Education Agency (LEA)	251300000X	None listed
Student Health Clinic/Center Primary	261QS1000X	None listed

Student Health Clinic/Center: Definition to come...

Another provider at this address

David Lawrence Brunken, ATCAthletic Trainer San Jacinto, CA NPI 1568428308

NPI record

NPI: 1205679339
Entity type: Organization (Type 2)
Issued: Jun 17, 2024
Last updated: Jul 29, 2024
Status: Active
Subpart: Yes of Mt. San Jacinto Community College District

Other names

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Mt. San Jacinto College · doing business as

Authorized official

Michael Beckham
Interim VP of Business Services
(951) 465-7939

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1205679339

Mt. San Jacinto Community College District's National Provider Identifier is 1205679339, issued on Jun 17, 2024. The primary taxonomy on file is Student Health Clinic/Center (261QS1000X), and the practice location is in San Jacinto, CA. The record was last updated on Jul 29, 2024.