RIVERSIDE REGIONAL PEDIATRIC MEDICAL GROUP, INC. (NPI# 1902987142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902987142 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE REGIONAL PEDIATRIC MEDICAL GROUP, INC. |
| Practice Address |
180 E 4th St # C Perris CA 92570-2125 |
| Practice Telephone | 9519438899 |
| Practice Fax Number | 9519434598 |
| Mailing Telephone | 9519438899 |
| Mailing Fax Number | 9519434598 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GUILLERMO VALENZUELA (PRESIDENT/OWNER) |
| Authorized Official Telephone | 9095806320 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL PROVIDER NUMBER | GR0086162 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437230687 | Riverside Regional Pediatric Medical Group, Inc. | Specialist | 12712 Heacock St Ste 3, Moreno Valley, CA 92553-3037 | 2006-10-17 |
| Street Address |
180 E 4TH ST # C |
| City | PERRIS |
| State | CA |
| Zip Code | 92570-2125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659861185 | Derriea Mcglothern | Specialist/Technologist | 23126 Rider St, Perris, CA 92570 | 2018-05-10 |
| 1790235109 | Jeromy Ford | Counselor | 226 W. 4th St, Perris, CA 92570 | 2016-10-10 |
| 1699196485 | Taniya Sweeney | Community/Behavioral Health | 413 South B Strret, Perris, CA 92570 | 2013-12-20 |
| 1790091718 | Josh B Neal | Counselor | 827 Georgiana Ct, Perris, CA 92570 | 2010-08-27 |
| 1427370915 | Riverside Recovery Resources | Clinic/Center | 13911 Perris Blvd, Perris, CA 92570 | 2010-02-24 |
| 1144471939 | Three Angels Medical Professional Corporation | Internal Medicine | 180 East 4th St, Suite B and C, Perris, CA 92570 | 2008-10-10 |
| 1205091790 | Jill None Demos | Counselor | 24050 Christmas Tree Lane, Perris, CA 92570 | 2008-07-23 |
| 1598929341 | Jacqueline Anne Rockwell | Counselor | 555 Perris Blvd, Peris, CA 92570 | 2008-07-10 |
| 1053584128 | Perris Union High School District | Local Education Agency (LEA) | 755-b North A Street, Perris, CA 92570 | 2008-04-09 |
| 1477735215 | Christianne Nelson | Case Management | 308 E San Jacinto Avenue, Perris, CA 92570 | 2007-12-04 |
| Find all providers in zip 92570 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508808916 | Healthpointe Medical Group, Inc. | Specialist | 2226 Medical Center Dr, 102, Perris, CA 92571-2657 | 2006-06-11 |
| 1477949709 | Three Angels Medical Professional Corp. | Specialist | 180 East 4th St, Suite B and C, Perris, CA 92570 | 2015-04-14 |
| 1053349258 | Healthpointe Medical Group Inc. | Specialist | 2226 Medical Center Dr, Perris, CA 92571-2657 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113072 | Jonalyn Coronel | Specialist | 653 Canyon Rd, Novato, CA 94947-4331 | 2020-10-28 |
| 1497353239 | Nadia Nodoust-christensen | Specialist | 1627 Curtis Ave, Manhattan Beach, CA 90266-7022 | 2020-10-14 |
| 1073111936 | Griffin Nutrition Xterem | Specialist | 21575 Dome Trl, Topanga, CA 90290-3645 | 2020-10-13 |
| 1811503162 | George Thomas Lafortune | Specialist | 7927 Painter Ave Ste 200, Whittier, CA 90602-2480 | 2020-09-22 |
| 1699383661 | Transgender Health and Wellness Center | Specialist | 6700 Indiana Ave Ste 252, Riverside, CA 92506-4264 | 2020-07-16 |
| 1700403524 | Kelly Phillips | Specialist | 4650 Fruitvale Rd, Newcastle, CA 95658-9240 | 2020-06-27 |
| 1417572462 | Sarah Velez | Specialist | 1001 Potrero Ave Rm 7g19, San Francisco, CA 94110-3518 | 2020-06-15 |
| 1295350668 | Bette Graff | Specialist | 4148 10th St, Riverside, CA 92501-3110 | 2020-06-11 |
| 1114541463 | Serena Mink | Specialist | 100 Park Plz Apt 407, San Diego, CA 92101-6710 | 2020-06-02 |
| 1811510043 | Michael J Kodrich | Specialist | 40555 California Oaks Rd, Murrieta, CA 92562-5723 | 2020-05-21 |
| 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.