INLAND EMPIRE AUTISM ASSESSMENT CENTER, A PSYCHOLOGICAL CORPORATION (NPI# 1467005579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467005579 |
| Entity Type | Organization |
| Organization Name | INLAND EMPIRE AUTISM ASSESSMENT CENTER, A PSYCHOLOGICAL CORPORATION |
| Practice Address |
19314 Jesse Ln Ste 200 Riverside CA 92508-5070 |
| Practice Telephone | 9097993777 |
| Practice Fax Number | 9097995999 |
| Mailing Telephone | 9097993777 |
| Mailing Fax Number | 9097995999 |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |
| Authorized Official Name | MR. ZACHARY DANE GINDER (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Telephone | 9097993777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 174400000X | Specialist | Other Service Providers | ||
| N | 2080P0008X |
Pediatrics Specialization: Neurodevelopmental Disabilities |
Allopathic & Osteopathic Physicians | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1499 S Tippecanoe Ave Bldg A, San Bernardino, CA 924082920 | 9097993777 |
| Street Address |
19314 JESSE LN STE 200 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92508-5070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205098068 | Michael B Cao | Clinical Neuropsychologist | 19314 Jesse Ln Ste 200, Riverside, CA 92508-5070 | 2008-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699257121 | Careconnexus, LLC | Non-emergency Medical Transport (VAN) | 9338 Millionaire Lane, Riverside, CA 92508 | 2018-08-31 |
| 1003265117 | Travis William Cruz | Physician Assistant | 9525 Los Amigos Court, Riverside, CA 92508 | 2016-06-09 |
| 1043610769 | Mountain Vista Medical Center | General Acute Care Hospital | 8168 Palm View Ln, Riverside, CA 92508 | 2014-08-29 |
| 1952642399 | John Lawrence Bowers | Marriage & Family Therapist | 19900 Grove Community Drive, Riverside, CA 92508 | 2013-03-11 |
| 1952605248 | Dennis Graves | Counselor | 17270 Roosevelt Ave, Riverside, CA 92508 | 2011-01-01 |
| 1811207632 | Bekele T Haimanot | Physician Assistant | 9528 Los Coches Court, Riverside, CA 92508 | 2010-10-14 |
| 1518144625 | Irene T. Zaki | Dentist | 20873 Grove Community Dr., Riverside, CA 92508 | 2008-01-31 |
| 1093902447 | Edward Keith Forward | Specialist | 18167 Kross Rd, Riverside, CA 92508 | 2007-10-01 |
| 1255523593 | Sopheap Tang | Dentist | 18876 Van Buren Blvd, Ste 107, Riverside, CA 92508 | 2007-08-10 |
| 1942336995 | Ching-roo Chi | Dentist | 473 E. Allessandro Blvd., Suite A, Riverside, CA 92508 | 2007-02-26 |
| Find all providers in zip 92508 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205098068 | Michael B Cao | Clinical Neuropsychologist | 19314 Jesse Ln Ste 200, Riverside, CA 92508-5070 | 2008-07-01 |
| 1699892166 | Irwin Savodnik, M.d. & Medical Associates, Inc. | Clinical Neuropsychologist | 4000 14th St Ste 405, Riverside, CA 92501-4010 | 2007-03-22 |
| 1851752521 | Brian Kavanaugh | Clinical Neuropsychologist | 1011 Veterans Memorial Pkwy, Riverside, RI 02915-5061 | 2016-03-09 |
| 1639469257 | Keith L. Drieberg | Clinical Neuropsychologist | 4500 Riverwalk Pkwy, Riverside, CA 92503 | 2011-04-16 |
| 1790889863 | Antonius D Brandon | Clinical Neuropsychologist | 5887 Brockton Ave, Riverside Psychiatric Medical Group Ste A, Riverside, CA 92506 | 2006-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455108 | Chelsea Vilinskas | Clinical Neuropsychologist | 2624 Larkey Ln, Walnut Creek, CA 94597-2439 | 2020-10-22 |
| 1417554049 | Andrea Alioto | Clinical Neuropsychologist | 247 San Carlos Ave, Redwood City, CA 94061-3518 | 2020-10-06 |
| 1265045975 | Well Psychology, Inc. | Clinical Neuropsychologist | 3525 Del Mar Heights Rd # 1881, San Diego, CA 92130-2199 | 2020-08-24 |
| 1922618917 | Alyssa Weakley | Clinical Neuropsychologist | Uc Davis Midtown Neurology Clinic, 3160 Folsom Blvd, Sacramento, CA 95816 | 2020-08-04 |
| 1437767399 | Ni Sun-suslow | Clinical Neuropsychologist | 220 Dickinson St # B, San Diego, CA 92103-2071 | 2020-07-16 |
| 1366061707 | Talia Rose Seider | Clinical Neuropsychologist | 760 Westwood Plz Ste 37-360b, Los Angeles, CA 90024-5055 | 2020-04-15 |
| 1699394270 | Colin Jarred Gallagher | Clinical Neuropsychologist | 760 Westwood Plz # C8-854, Los Angeles, CA 90095-8353 | 2020-04-13 |
| 1649807058 | Nicholas S. Thaler Phd A Psychological Corporation | Clinical Neuropsychologist | 1526 14th St Ste 109, Santa Monica, CA 90404-3320 | 2020-03-25 |
| 1447890116 | Hussah Alkharafi | Clinical Neuropsychologist | 2720 Neilson Way # 5701, Santa Monica, CA 90405-4060 | 2020-01-10 |
| 1609414788 | Linda Rice | Clinical Neuropsychologist | 617 Bluegrass St, Simi Valley, CA 93065-5460 | 2019-12-19 |
| 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.