RIVERSIDE PSYCHIATRIC MEDICAL GROUP (NPI# 1972691228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972691228 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE PSYCHIATRIC MEDICAL GROUP |
| Other Organization Name | RIVERSIDE PSYCH MED GROUP |
| Practice Address |
5887 Brockton Ave Ste A Riverside Psychiatric Medical Group Riverside CA 92506 |
| Practice Telephone | 9512758500 |
| Practice Fax Number | 9512758560 |
| Mailing Telephone | 9512758500 |
| Mailing Fax Number | 9512758560 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2013-12-20 |
| Authorized Official Name | MR. ROBERT B. SUMMEROUR (OWNER) |
| Authorized Official Telephone | 9512758500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Riverside Psych Med Group | Other Name - Individual/Organization |
| Street Address |
5887 BROCKTON AVE STE A RIVERSIDE PSYCHIATRIC MEDICAL GROUP |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164526232 | Kathryn Virginia Mantz | Psychologist | 5887 Brockton Ave, Riverside Psychiatric Medical Group Ste A, Riverside, CA 92506 | 2006-09-11 |
| 1184270381 | Jessica Nicole Rodello | Nurse Practitioner | 5887 Brockton Ave, Riverside, CA 92506-1853 | 2019-08-13 |
| 1821569765 | Christianne Zah-weber | Nurse Practitioner | 5887 Brockton Ave, Riverside, CA 92506-1853 | 2018-12-17 |
| 1568852473 | Ucr Health Psychiatry - Brockton | Clinic/Center | 5887 Brockton Ave, Suite A, Riverside, CA 92506-1853 | 2015-01-29 |
| 1336566348 | Scott Veltre | Clinical Nurse Specialist | 5887 Brockton Ave, Suite A, Riverside, CA 92506-1853 | 2014-03-27 |
| 1952558041 | Enn Magi | Psychiatry & Neurology | 5887 Brockton Ave, Riverside, CA 92506-1858 | 2008-08-20 |
| 1689858417 | Kathleen A Kelly | Counselor | 5887 Brockton Ave, Suite A, Riverside, CA 92506-1858 | 2007-12-28 |
| 1649346941 | Xiaoying Cui | Psychiatry & Neurology | 5887 Brockton Ave, Suite A Riverside Psychiatric Medical Group, Riverside, CA 92506 | 2006-11-28 |
| 1497837686 | Carol J. Appleton | Physical Therapist | 5887 Brockton Ave, Suite B, Riverside, CA 92506-1858 | 2006-10-19 |
| 1811085160 | Robert Brooke Summerour | Psychiatry & Neurology | 5887 Brockton Ave, Suite A Riverside Psychiatric Medical Group, Riverside, CA 92506 | 2006-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902405715 | Riverside Primary Care Clinic, Joanna Ayala Md | Clinic/Center | 3978 Merrill Ave, Riverside, CA 92506 | 2020-10-22 |
| 1336747005 | Beatriz Arredondo | Behavioral Analyst | 6117 Brockton Avenue Ste. 202, Riverside, CA 92506 | 2020-10-14 |
| 1740756782 | Priscilla Marie Rodriguez | Social Worker | 3742 Tibbets St Suite 201, Riverside, CA 92506 | 2018-10-17 |
| 1922593946 | Prevail Health Solutions, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 7450 Chateau Ridge Ln, Riverside, CA 92506 | 2018-06-22 |
| 1831691880 | Mckinley Children's Center | Community/Behavioral Health | 6700 Indiana Avenue, Suite 280, Riverside, CA 92506 | 2018-03-06 |
| 1720590946 | Leticia Dilworth | Behavioral Analyst | 3610 Central Ave Ste 46, Riverside, CA 92506 | 2017-10-27 |
| 1548771736 | Usa Biosciences LLC | Clinical Medical Laboratory | 5750 Division St Ste 109, Riverside, CA 92506 | 2017-10-16 |
| 1922542273 | Yazmar Sevilla-perez | Physical Therapist | 6852 Brockton Ave., Suite 212, Riverside, CA 92506 | 2016-12-06 |
| 1821547605 | Pathway To Healing, Marriage and Family Therapy, Inc. | Marriage & Family Therapist | 5790 Magnolia Ave., Ste 202, Rm F, Riverside, CA 92506 | 2016-09-22 |
| 1952857542 | Kramer and Nguyen Dental Corporation | Dentist | 3602 Riverside Plaza Dr, Ste 101, Riverside, CA 92506 | 2016-09-01 |
| Find all providers in zip 92506 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346753290 | Tessie Cleveland Community Services Corporation | Clinic/Center | 3576 Arlington Ave Ste 100&104, Riverside, CA 92506-3943 | 2017-11-14 |
| 1871012203 | Healing Hearts Marriage and Family Therapy, Inc. | Clinic/Center | 3610 Central Ave Ste 400, Riverside, CA 92506-5907 | 2017-09-18 |
| 1164843074 | Telecare Corporation | Clinic/Center | 2020 Iowa Avenue, Suite 101, Riverside, CA 92507-7428 | 2013-12-18 |
| 1285824813 | Central Medical & Behavioral Center | Clinic/Center | 4230 Central Avenue, Riverside, CA 92504-2919 | 2007-07-30 |
| 1902422124 | All Minds Clear Family Therapy, Inc. | Clinic/Center | 7121 Magnolia Ave Ste J, Riverside, CA 92504-3805 | 2020-06-23 |
| 1588294557 | Finding Love for Today Christian Counseling Services | Clinic/Center | 3400 Central Ave Ste 310, Riverside, CA 92506-2181 | 2020-01-18 |
| 1427566975 | Tara Andrea Coronel | Clinic/Center | 3125 Myers St, Riverside, CA 92503-5527 | 2018-01-18 |
| 1609239920 | East Bay Community Action Program | Clinic/Center | 100 Bullocks Point, Riverside, RI 02915 | 2016-04-04 |
| 1861875924 | Ucr Health - Riverside County Mental Health Dept. | Clinic/Center | 4095 County Circle Dr, Riverside, CA 92503-3410 | 2015-07-07 |
| 1568852473 | Ucr Health Psychiatry - Brockton | Clinic/Center | 5887 Brockton Ave, Suite A, Riverside, CA 92506-1853 | 2015-01-29 |
| Find all providers in RIVERSIDE | ||||
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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.