PITUCK MEDICAL GROUP, INC. (NPI# 1255544557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255544557 |
| Entity Type | Organization |
| Organization Name | PITUCK MEDICAL GROUP, INC. |
| Practice Address |
5858 Magnolia Ave Ste C Riverside CA 92506-1886 |
| Mailing Address |
432 Somerset Dr Placentia CA 92870-2025 |
| Practice Telephone | 7142230396 |
| Practice Fax Number | 7142230397 |
| Mailing Telephone | 7142230396 |
| Mailing Fax Number | 7142230397 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-12-04 |
| Authorized Official Name | MICHELE SEVERSON (ADMINISTRATOR) |
| Authorized Official Telephone | 7142230396 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
Behavioral Health & Social Service Providers |
| Street Address |
5858 MAGNOLIA AVE STE C |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92506-1886 |
| 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 | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043691025 | New Day Institute | Psychologist | 6391 Magnolia Ave, Suite A, Riverside, CA 92506-2424 | 2015-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770985004 | M2 Creative | Psychologist | 6715 Melrose Ave, Los Angeles, CA 90038-3411 | 2014-09-18 |
| 1508294083 | Silverlining Psychiatry Medical Group | Psychologist | 3252 Holiday Ct Ste 108, La Jolla, CA 92037-1807 | 2013-10-21 |
| 1235408089 | Behavioral Research Specialists, LLC | Psychologist | 230 N. Maryland Ave, #309, Glendale, CA 91206 | 2011-12-23 |
| 1730342957 | United Behavioral Center, Inc | Psychologist | 834 W Avenue J, Lancaster, CA 93534-3427 | 2008-07-08 |
| 1528245917 | Claude E. Arnett | Psychologist | 403 N Susan St, Santa Ana, CA 92703-3433 | 2008-01-28 |
| 1811102908 | Mary Ann Barr | Psychologist | 277 Cascade Dr, Mill Valley, CA 94941-5025 | 2007-05-11 |
| 1932320389 | Ricque L. Brister | Psychologist | 56 Hanover Ln, Suite., 100, Chico, CA 95973-7230 | 2007-05-02 |
| 1013539121 | Sally Kei Mason | Psychologist | 510 Plaza Dr Ste 170, Folsom, CA 95630-4790 | 2020-05-12 |
| 1104183292 | Socal Center for Change | Psychologist | 1110 E Chapman Ave, Suite 204, Orange, CA 92866-2139 | 2012-04-13 |
| 1619264389 | Fred Finch Youth Center | Psychologist | 4351 Broadway, Oakland, CA 94611-4612 | 2011-07-01 |
| Find all providers with the same taxonomy | ||||
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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.