EVERSIDE HEALTH-VICTORVILLE
NPI 1063193852
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Victorville, CA

Active since July 26, 2023CLIA 31D2270637 · Waiver
15632 BEAR VALLEY RD STE 104, VICTORVILLE, CA 92395(704) 661-1380 Get Directions Write a Review

NPPES record last updated: July 26, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Everside Health-victorville NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERSIDE HEALTH-VICTORVILLE (NPI 1063193852) is a healthcare organization registered as a preventive medicine/occupational environmental medicine in Victorville, California and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through October 18, 2026 and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1063193852
Entity TypeOrganization
Primary Taxonomy2083P0500X
Legal Business NameEVERSIDE HEALTH-VICTORVILLE
Location Address15632 BEAR VALLEY RD STE 104Victorville, CA 92395-8518
Mailing Address4651 Charlotte Park Dr Ste 300Charlotte, NC 28217-1916
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateJuly 26, 2023
NPPES CertifiedJuly 26, 2023
NPI 1063193852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPreventive Medicine · Preventive Medicine/Occupational Environmental MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083P0500X
Definition

A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.

15632 BEAR VALLEY RD STE 104, Victorville, CA 92395

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2270637

Everside Health LLC - Willingboro · Willingboro, NJ
Active · expires Oct 18, 2026
CLIA Number31D2270637
Laboratory TypePhysician Office
Certificate Effective DateOctober 19, 2024
Certificate Expiration DateOctober 18, 2026
Laboratory DirectorJanine Beckles
Laboratory Phone(704) 661-1380
Laboratory LocationEverside Health LLC - Willingboro630 Beverly-Rancocas Road, Willingboro, NJ 08046
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Everside Health-Victorville's NPI number?

The NPI number for Everside Health-Victorville is 1063193852. It was assigned to this organization in the NPPES registry on July 26, 2023.

Where is Everside Health-Victorville located?

Everside Health-Victorville is located at 15632 Bear Valley Rd Ste 104, Victorville, CA 92395. The listed phone number is (704) 661-1380.

What is Everside Health-Victorville's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Preventive Medicine/Occupational Environmental Medicine, with taxonomy code 2083P0500X.

Does Everside Health-Victorville hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2270637) is associated with this NPI, valid through October 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Everside Health-Victorville was last updated on July 26, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.