COUNTY OF RIVERSIDE (NPI# 1528242799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528242799 |
| Entity Type | Organization |
| Organization Name | COUNTY OF RIVERSIDE |
| Other Organization Name | MHSA FSP MDFT LAKE ELSINORE |
| Practice Address |
31946 Mission Trl Ste B Lake Elsinore CA 92530-4539 |
| Mailing Address |
Po Box 7659 Riverside CA 92513 |
| Practice Telephone | 9514432200 |
| Mailing Telephone | 9513586900 |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | DR. MATTHEW CHANG (DIRECTOR OF MENTAL HEALTH) |
| Authorized Official Telephone | 9513584500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LEGAL ENTITY | 00033 | 01 |
| Other Name | Type Code |
|---|---|
| MHSA FSP MDFT Lake Elsinore | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821618588 | County of Riverside | Community/Behavioral Health | 63 S 4th St, Banning, CA 92220-4861 | 2020-04-23 |
| 1003436940 | County of Riverside | Community/Behavioral Health | 1225 W Hobsonway, Blythe, CA 92225-1423 | 2020-04-21 |
| 1457971301 | County of Riverside | Community/Behavioral Health | 65753 Pierson Blvd, Desert Hot Springs, CA 92240-3067 | 2020-04-21 |
| 1184244345 | County of Riverside | Community/Behavioral Health | 1283 6th St, Coachella, CA 92236-1707 | 2020-04-17 |
| 1386264562 | County of Riverside | Community/Behavioral Health | 517 Parkridge Ave, Norco, CA 92860-3103 | 2020-04-17 |
| 1942839816 | County of Riverside | Community/Behavioral Health | 91-275 Ave 66, Mecca, CA 92254 | 2020-04-03 |
| 1235768110 | County of Riverside | Community/Behavioral Health | 82675 Us Highway 111, Indio, CA 92201-5635 | 2020-04-03 |
| 1609408178 | County of Riverside | Pharmacy | 26600 Cactus Ave, Moreno Valley, CA 92555-3901 | 2020-02-12 |
| 1982243812 | County of Riverside | Clinic/Center | 26600 Cactus Ave Ste 300, Moreno Valley, CA 92555-3901 | 2019-12-23 |
| 1467943811 | County of Riverside | Community/Behavioral Health | 249 N Spring St, Blythe, CA 92225 | 2018-05-22 |
| Street Address |
31946 MISSION TRL STE B |
| City | LAKE ELSINORE |
| State | CA |
| Zip Code | 92530-4539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710021316 | Saira Prudencio | Marriage & Family Therapist | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2007-02-16 |
| 1871103598 | Laura A Alba | Student in an Organized Health Care Education/Training Program | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2020-08-06 |
| 1770193930 | Luisana Suchilt | Psychologist | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2020-08-03 |
| 1649895558 | Jamie Moss | Marriage & Family Therapist | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2020-06-16 |
| 1770117434 | Haidee R Gomez | Case Manager/Care Coordinator | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2020-03-02 |
| 1255976080 | Vanessa Valeria Valenzuela | Student in an Organized Health Care Education/Training Program | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2019-11-15 |
| 1356999049 | Gloria Montes Cardona | Peer Specialist | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2019-08-27 |
| 1427512656 | Dale Allen Green Jr. | Case Manager/Care Coordinator | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2019-01-22 |
| 1700310745 | La Trise Robinson | Peer Specialist | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2017-04-17 |
| 1770026296 | Laura Lashaye Brown | Marriage & Family Therapist | 31946 Mission Trl Ste B, Lake Elsinore, CA 92530-4539 | 2016-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1700423779 | Karrene Louise Stanard | Peer Specialist | 31764 Casino Drive, Suite 300, Lake Elsinore, CA 92530 | 2019-12-09 |
| 1972149961 | Danielle Cravalho | Student in an Organized Health Care Education/Training Program | 31964 Mission Trail, Suite B, Lake Elsinore, CA 92530 | 2019-11-25 |
| 1952825648 | R.e. Levi Dental Corporation | Dentist | 32235 Mission Trail # 8, Lake Elsinore, CA 92530 | 2017-08-03 |
| 1144760729 | Alfred Metwashla | Pharmacist | 18269 Collier Ave, Lake Elsinore, CA 92530 | 2017-03-02 |
| 1750788733 | Roxanne Martinez | Case Manager/Care Coordinator | 31764 Casino Drive, Lake Elsinore, CA 92530 | 2014-11-19 |
| 1871870907 | Bryan Tuan Tran | Pharmacist | 160 Diamond Drive, Lake Elsinore, CA 92530 | 2011-11-03 |
| 1043590821 | Katherynn Elizabeth Williams | Marriage & Family Therapist | 600 Central Ave Ste 201, Lake Elsinore, CA 92530 | 2011-08-24 |
| 1861771677 | Judy Kelly | Marriage & Family Therapist | 224 West Graham Ave, Lake Elsinore, CA 92530 | 2011-08-10 |
| 1427343813 | Patrick Chern | Pharmacist | 18287 Collier Ave., Lake Elsinore, CA 92530 | 2011-06-14 |
| Find all providers in zip 92530 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871924928 | County of Riverside | Community/Behavioral Health | 31760 & 31764 Casino Dr, Lake Elsinore, CA 92530-4561 | 2013-11-27 |
| 1588967772 | Mfi Recovery Center | Community/Behavioral Health | 1405 Education Way, Lake Elsinore, CA 92530-2809 | 2010-12-10 |
| 1033412226 | Mfi Recovery Center | Community/Behavioral Health | 32593 Riverside Dr, Lake Elsinore, CA 92530-7802 | 2010-12-10 |
| 1093018186 | Mfi Recovery Center | Community/Behavioral Health | 520 Chaney St Bldg 100, Lake Elsinore, CA 92530-2711 | 2010-12-10 |
| 1346860210 | County of Riverside | Community/Behavioral Health | 1400 W Minthorn St, Lake Elsinore, CA 92530-2808 | 2020-04-21 |
| 1831640358 | Corc Family Counseling Corporation | Community/Behavioral Health | 224 W Graham Ave, Lake Elsinore, CA 92530-3740 | 2016-10-19 |
| 1982094629 | County of Riverside | Community/Behavioral Health | 31760 Casino Dr, Suite 100, Lake Elsinore, CA 92530-4561 | 2015-02-03 |
| 1356748628 | County of Riverside | Community/Behavioral Health | 31764 Casino Dr, Suite 300, Lake Elsinore, CA 92530-4571 | 2014-12-02 |
| 1225331416 | Mfi Temescal Canyon High School | Community/Behavioral Health | 28755 El Toro Rd, Lake Elsinore, CA 92532-1912 | 2010-12-10 |
| 1518298702 | Community Access Network | Community/Behavioral Health | 600 Central Ave, Suite E1, Lake Elsinore, CA 92530-2740 | 2010-01-27 |
| Find all providers in LAKE ELSINORE | ||||
| City | LAKE ELSINORE |
| Zip Code | 92530 |
Please comment or provide details below to improve the information on COUNTY OF RIVERSIDE.
| 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.