FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1487603924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487603924 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
11130 Anderson St Suite 117 Loma Linda CA 92354-2802 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-0001 |
| Practice Telephone | 9095588576 |
| Practice Fax Number | 9095583905 |
| Mailing Telephone | 9095583111 |
| Mailing Fax Number | 9095583905 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-07-19 |
| Authorized Official Name | RICARDO PEVERINI (PRESIDENT) |
| Authorized Official Telephone | 9095587448 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GPS000762 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144477 | Faculty Physicians and Surgeons of Llusm | Neurological Surgery | 35400 Bob Hope Dr Ste 110, Rancho Mirage, CA 92270-1772 | 2020-11-04 |
| 1700495363 | Faculty Physicians and Surgeons of Llusm | Radiology | 1850 N Riverside Ave Ste 160, Rialto, CA 92376-8056 | 2020-07-29 |
| 1326665415 | Faculty Physicians and Surgeons of Llusm | Otolaryngology | 4646 Brockton Ave Ste 103, Riverside, CA 92506-0103 | 2020-07-06 |
| 1790326825 | Faculty Physicians and Surgeons of Llusm | Urology | 11360 Mt View Ave Ste B, Loma Linda, CA 92354-3834 | 2019-09-30 |
| 1932600335 | Faculty Physicians and Surgeons of Llusm | Internal Medicine | 1200 California St Ste 270, Redlands, CA 92374-2970 | 2018-02-22 |
| 1386162949 | Faculty Physicians and Surgeons of Llusm | Internal Medicine | 197 E Caroline St, San Bernardino, CA 92408 | 2017-09-05 |
| 1588034169 | Faculty Physicians and Surgeons of Llusm | Physician Assistant | 350 S Euclid Ave, Unit C, Upland, CA 91786-6665 | 2015-09-25 |
| 1912343104 | Faculty Physicians and Surgeons of Llusm | Pediatrics | 1101 N Euclid Ave, Upland, CA 91786-3233 | 2013-05-15 |
| 1457680530 | Faculty Physicians and Surgeons of Llusm | Pediatrics | 12021 Jacaranda Ave., Hesperia, CA 92345-4956 | 2009-12-18 |
| 1265686109 | Faculty Physicians and Surgeons of Llusm | Pathology | 11234 Anderson St Ste 1617, Loma Linda, CA 92354-2804 | 2008-11-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FACULTY PHYSICIANS AND SURGEONS OF LLUSM | 11370 Anderson St, Loma Linda, CA 92354-3450 |
| Street Address |
11130 ANDERSON ST SUITE 117 |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92354-2802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508421645 | Bianca Lizett Avila | Dietitian, Registered | 11130 Anderson St, Loma Linda, CA 92350-1729 | 2019-05-03 |
| 1851746382 | Jerry Slater | Student in an Organized Health Care Education/Training Program | 11130 Anderson St, Loma Linda, CA 92350-1729 | 2016-05-03 |
| 1740572965 | Bridgette J Peteet | Psychologist | 11130 Anderson St, Loma Linda, CA 92350-1729 | 2011-05-05 |
| 1639497944 | Adam Lapree Arechiga | Psychologist | 11130 Anderson St, Loma Linda, CA 92354-2802 | 2010-05-11 |
| 1154401552 | Louis Jenkins | Psychologist | 11130 Anderson St, Ste 117, Loma Linda, CA 92354-2802 | 2006-10-17 |
| 1124139399 | David A Vermeersch | Psychologist | 11130 Anderson St, Ste 117, Loma Linda, CA 92354-2802 | 2006-08-31 |
| 1235240490 | Kendal C Boyd | Psychologist | 11130 Anderson St, Ste 117, Loma Linda, CA 92354-2802 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1013517960 | Kristina Pulliam Markey | Nurse Practitioner | 11234 Anderson Strreet, Loma Linda, CA 92354 | 2020-10-29 |
| 1932725645 | Dev Priya Singhvi | Student in an Organized Health Care Education/Training Program | 11332 Mountain View Avenue, Westerly Building, Suite C, Gme Office, Loma Linda, CA 92354 | 2020-06-18 |
| 1750901278 | Angela N Torres | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Emergency Medicine, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-04-24 |
| 1548899230 | Holistic Physical Therapy Inc. | Physical Therapist | 25003 Starr Str, Loma Linda, CA 92354 | 2020-04-03 |
| 1508494071 | Eric Allen | Student in an Organized Health Care Education/Training Program | Loma Linda University Health Pediatrics, General, 11234 Anderson Street, Loma Linda, CA 92354 | 2020-03-31 |
| 1730640244 | Rose Valley Rcfe | Assisted Living Facility | 11574 Poplar St, Loma Linda, CA 92354 | 2019-03-27 |
| 1336633676 | David A Lawrence | Student in an Organized Health Care Education/Training Program | Loma Linda University Hospital, 11234 Anderson St., Loma Linda, CA 92354 | 2018-06-20 |
| 1205329547 | Rachael Nicole Spady | Student in an Organized Health Care Education/Training Program | Loma Linda University Health - Obstetrics & Gynecology, 11234 Anderson St, Loma Linda, CA 92354 | 2018-06-12 |
| 1447756069 | Anthony Ernest Sanchez | Otolaryngology | 11332 Mountain View, Westerly Building Suite C, Loma Linda, CA 92354 | 2018-04-03 |
| Find all providers in zip 92354 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710535968 | Inland Psychiatric Medical Group Inc | Psychologist | 11306 Mountain View Ave Ste A, Loma Linda, CA 92354-3832 | 2019-08-30 |
| 1982705091 | Virginia May Tams | Psychologist | 11486 Benton St, Loma Linda, CA 92354-3680 | 2006-09-25 |
| 1033159686 | Diane E. Bunker | Psychologist | Jerry L. Pettis Vamc, 11201 Benton Street, Loma Linda, CA 92357-0001 | 2006-06-08 |
| 1275088262 | Veronica Llamas | Psychologist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2016-08-18 |
| 1588117071 | Jessica Briana Mcclintock | Psychologist | 25455 Barton Rd Ste 204b, Loma Linda, CA 92354-3130 | 2016-08-01 |
| 1346610979 | Gregory Scott Foley | Psychologist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2015-09-24 |
| 1619303161 | Elizabeth Welsh | Psychologist | 11201 Benton St, 116a, Loma Linda, CA 92357-1000 | 2013-09-16 |
| 1164770210 | Anna Marie Medina | Psychologist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2012-08-21 |
| 1548543382 | Kendra Tracy | Psychologist | 11201 Benton St, Loma Linda, CA 92357-1000 | 2011-09-27 |
| 1932347481 | Kimberly R Freeman | Psychologist | 11370 Anderson St Ste B100, Loma Linda, CA 92354-3450 | 2009-01-21 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92354 |
Please comment or provide details below to improve the information on FACULTY PHYSICIANS AND SURGEONS OF LLUSM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.