FACULTY PHYSICIANS AND SURGEONS OF LLUSM (NPI# 1558311373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558311373 |
| Entity Type | Organization |
| Organization Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Practice Address |
1686 Barton Rd Redlands CA 92373-7761 |
| Mailing Address |
File Number 54701 Los Angeles CA 90074-0001 |
| Practice Telephone | 9095584505 |
| Mailing Telephone | 9095583111 |
| Enumeration Date | 2006-05-11 |
| 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 |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GPS000760 | 05 | |
| CA | GR0069028 | 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 |
1686 BARTON RD |
| City | REDLANDS |
| State | CA |
| Zip Code | 92373-7761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841717220 | Amber Moland | Behavioral Analyst | 1686 Barton Rd, Redlands, CA 92373-1488 | 2017-08-25 |
| 1972020840 | Jessica Nicole Leigh | Behavioral Analyst | 1686 Barton Rd, Redlands, CA 92373-1488 | 2017-08-23 |
| 1720500457 | Loma Linda University Behavioral Medicine Center, Inc. | Psychiatric Hospital | 1686 Barton Rd, Redlands, CA 92373-1488 | 2017-07-14 |
| 1609317098 | Jenny Haeyeon Lee | Psychologist | 1686 Barton Rd, Redlands, CA 92373-1488 | 2017-03-17 |
| 1750735650 | Neal Ryan Christopher | Psychiatry & Neurology | 1686 Barton Rd, Redlands, CA 92373 | 2016-04-17 |
| 1679948103 | Don Mellor Jr. | Psychologist | 1686 Barton Rd, Redlands, CA 92373-1488 | 2015-12-09 |
| 1922354349 | Loma Linda University | Social Worker | 1686 Barton Rd, Redlands, CA 92373-1488 | 2012-08-03 |
| 1366701401 | Katia Sirel Stoletniy | Psychiatry & Neurology | 1686 Barton Rd, Redlands, CA 92373-1488 | 2012-05-10 |
| 1114217619 | Darcy Trenkle | Psychiatry & Neurology | 1686 Barton Rd, Box E, Redlands, CA 92373-1488 | 2011-04-18 |
| 1205155751 | Jennifer Minami | Psychiatry & Neurology | 1686 Barton Rd, Redlands, CA 92373 | 2010-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473422 | Mindfulness Counseling Services | Marriage & Family Therapist | 101 E. Redlands, Suite 170a, Redlands, CA 92373 | 2020-09-24 |
| 1710596721 | Vandna Mittal | Counselor | 26967 Beamount Avenue, 1020 Coronado Drive, Redlands, CA 92373 | 2020-07-26 |
| 1164062345 | Sara Bencoe | Nurse Practitioner | 101 E. Redlands Blvd. Ste. 106, Redlands, CA 92373 | 2020-01-15 |
| 1033604103 | John Duane Wuchenich | Anesthesiology | 451 Summit Avenue, Redlands, CA 92373 | 2018-06-29 |
| 1013401074 | Adept Hospice Care | Hospice Care, Community Based | 515 New Jersey St., Suite G, Redlands, CA 92373 | 2018-06-21 |
| 1134616121 | Rodrigo Robles | Student in an Organized Health Care Education/Training Program | 26001 Redlands Blvd ., 2nd Floor, 2d 301, Redlands, CA 92373 | 2018-04-16 |
| 1760987614 | Redlands Endodontics | Dentist | 245 Terracina Blvd Suite 207 B, Redlands, CA 92373 | 2018-03-23 |
| 1487164166 | Tyler Stafford | Behavioral Analyst | 1467 Ford St. Suite 104, Redlands, CA 92373 | 2017-10-06 |
| 1083131486 | Shannon Palmowski | Behavioral Analyst | Institute for Behavioral Health, 1041 Alabama Ave, Redlands, CA 92373 | 2017-08-25 |
| 1275062622 | Erim Sarbuland | Marriage & Family Therapist | 101 East Redlands Boulevard, Suites #215, Redlands, CA 92373 | 2017-06-08 |
| Find all providers in zip 92373 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114269685 | Neelima Kunam | Psychiatry & Neurology | 1809 W Redlands Blvd Ste 103, Redlands, CA 92373-8054 | 2013-03-22 |
| 1609168897 | Mina Youssef | Psychiatry & Neurology | 26325 Snowden Ave, Redlands, CA 92374 | 2011-05-06 |
| 1982800033 | Chadwick Burgdorff | Psychiatry & Neurology | 1540 Barton Rd Ste 101, Redlands, CA 92373-5439 | 2007-06-25 |
| 1760516439 | Stephen Edward Salenger | Psychiatry & Neurology | 12606 Valley View Ln, Redlands, CA 92373-7464 | 2007-03-15 |
| 1740349307 | Nenita C. Belen | Psychiatry & Neurology | 1809 W. Redlands Boulevard, Redlands, CA 92373-6720 | 2006-12-08 |
| 1790709095 | Stephanie Lauralynn Bolton | Psychiatry & Neurology | 1686 Barton Rd Ste D, Redlands, CA 92373-1489 | 2006-07-27 |
| 1275565533 | Faculty Physicians and Surgeons of Llusm | Psychiatry & Neurology | 1710 Barton Rd, Redlands, CA 92373-5304 | 2006-07-07 |
| 1629020169 | Taghi Malekzadeh | Psychiatry & Neurology | 1732 Morning Dove Ln, Redlands, CA 92373-4315 | 2006-05-16 |
| 1609834936 | John Paul Riesenman | Psychiatry & Neurology | 255 Terracina Blvd Ste 204, Redlands, CA 92373-4870 | 2006-05-03 |
| 1578525499 | Syam P Kunam | Psychiatry & Neurology | 1809 W Redlands Blvd, Redlands, CA 92373-8054 | 2006-04-05 |
| Find all providers in REDLANDS | ||||
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| 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.