| Inland Psychiatric Medical Group, Inc. | |
|
1809 W Redlands Blvd Redlands CA 92373-8054 | |
| (909) 335-3026 | |
| (909) 335-3167 |
| Full Name | Inland Psychiatric Medical Group, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1809 W Redlands Blvd, Redlands, California |
| Authorized Official Name and Position | Syam P Kunam (CEO) |
| Authorized Official Contact | 9093353026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inland Psychiatric Medical Group, Inc. 1809 W Redlands Blvd Redlands CA 92373-8054 Ph: (909) 307-1320 | Inland Psychiatric Medical Group, Inc. 1809 W Redlands Blvd Redlands CA 92373-8054 Ph: (909) 335-3026 |
| NPI Number | 1649217761 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 09/10/2019 |
| Medicare PECOS PAC ID | 9436062312 |
|---|---|
| Medicare Enrollment ID | O20031106000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649217761 | NPI | - | NPPES |
| Provider Name | Henry H Khin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871639682 PECOS PAC ID: 6002729076 Enrollment ID: I20031106000689 |
| Provider Name | Visit Chatsuthiphan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861459109 PECOS PAC ID: 0547173197 Enrollment ID: I20031110000371 |
| Provider Name | Kamel L Kamel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811938541 PECOS PAC ID: 5496749384 Enrollment ID: I20040413001138 |
| Provider Name | Martha N Adigwe-mozia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225186133 PECOS PAC ID: 5799745204 Enrollment ID: I20041018001274 |
| Provider Name | Viswanatha J Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497804777 PECOS PAC ID: 5294796223 Enrollment ID: I20050222000836 |
| Provider Name | Robert C Krueger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174606255 PECOS PAC ID: 7911953484 Enrollment ID: I20050328000813 |
| Provider Name | Dawn Marie M Risley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144280231 PECOS PAC ID: 9032156070 Enrollment ID: I20050412000597 |
| Provider Name | Anindita Ganguly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740317254 PECOS PAC ID: 2163462870 Enrollment ID: I20050512000838 |
| Provider Name | Julie G Wareham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801853114 PECOS PAC ID: 9638082522 Enrollment ID: I20070622000566 |
| Provider Name | Grace Reid |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881747889 PECOS PAC ID: 5294826608 Enrollment ID: I20070814000238 |
| Provider Name | Sherry J Glover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831263672 PECOS PAC ID: 7012007156 Enrollment ID: I20071213000309 |
| Provider Name | Sultana Ikramullah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326065210 PECOS PAC ID: 7911950563 Enrollment ID: I20080110000459 |
| Provider Name | George P Solovjev |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922120963 PECOS PAC ID: 1355425042 Enrollment ID: I20080219000505 |
| Provider Name | Susan Crimin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194814707 PECOS PAC ID: 4082786116 Enrollment ID: I20080708000113 |
| Provider Name | Nenita C Belen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740349307 PECOS PAC ID: 2567525223 Enrollment ID: I20090107000418 |
| Provider Name | Scott M Steiglitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356418370 PECOS PAC ID: 2769545433 Enrollment ID: I20090107000499 |
| Provider Name | Tapeesh Kansal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841291408 PECOS PAC ID: 7113816455 Enrollment ID: I20090130000534 |
| Provider Name | Santokh Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851598924 PECOS PAC ID: 1254489107 Enrollment ID: I20090501000387 |
| Provider Name | Syam P Kunam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578525499 PECOS PAC ID: 9739092610 Enrollment ID: I20090529000117 |
| Provider Name | Anthony M Duk |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154439131 PECOS PAC ID: 2062564479 Enrollment ID: I20090716000150 |
| Provider Name | Juvvala M Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205919503 PECOS PAC ID: 9436297298 Enrollment ID: I20091116000337 |
| Provider Name | Anicia J Policar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659403467 PECOS PAC ID: 1456490010 Enrollment ID: I20091120000483 |
| Provider Name | Christopher Sangdahl |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700838109 PECOS PAC ID: 8325187800 Enrollment ID: I20091121000058 |
| Provider Name | Ellen Zuravel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295805059 PECOS PAC ID: 7719029917 Enrollment ID: I20100127000217 |
| Provider Name | Myra M Lamers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316059470 PECOS PAC ID: 6800082579 Enrollment ID: I20101119000546 |
| Provider Name | Jorge Trujillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801978374 PECOS PAC ID: 2264629757 Enrollment ID: I20101209000795 |
| Provider Name | Robert J Manriquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174620868 PECOS PAC ID: 7113115742 Enrollment ID: I20101227000617 |
| Provider Name | Daniel M Siegel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518163096 PECOS PAC ID: 8820287675 Enrollment ID: I20110110000052 |
| Provider Name | Hozair M Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235342098 PECOS PAC ID: 1254410939 Enrollment ID: I20110307000775 |
| Provider Name | Harbans S Multani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831175033 PECOS PAC ID: 3577590488 Enrollment ID: I20110706000181 |
| Provider Name | Nabi Ghulam Latif |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386841500 PECOS PAC ID: 0446437768 Enrollment ID: I20110908002157 |
| Provider Name | Matthew R Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033240080 PECOS PAC ID: 6709059207 Enrollment ID: I20111028000123 |
| Provider Name | John J Kohut |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992807143 PECOS PAC ID: 5395638126 Enrollment ID: I20111117000657 |
| Provider Name | Roger L Girion |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386912806 PECOS PAC ID: 3971761701 Enrollment ID: I20120223000913 |
| Provider Name | Tejon Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285911214 PECOS PAC ID: 3476716507 Enrollment ID: I20120529000477 |
| Provider Name | Maria G Chavez-brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073873626 PECOS PAC ID: 7517120538 Enrollment ID: I20120531000182 |
| Provider Name | Serafin Tambaoan Lalas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700050515 PECOS PAC ID: 2264683648 Enrollment ID: I20121112000490 |
| Provider Name | Sigrid M Formantes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881840023 PECOS PAC ID: 0244391498 Enrollment ID: I20121114000069 |
| Provider Name | Gayani Desilva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942353230 PECOS PAC ID: 6507895844 Enrollment ID: I20130802000809 |
| Provider Name | Reshma Ds Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790999167 PECOS PAC ID: 6901962448 Enrollment ID: I20130815000643 |
| Provider Name | Jennifer Onyekonwu-mcgill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063686616 PECOS PAC ID: 5092958322 Enrollment ID: I20130905000243 |
| Provider Name | Khadija H Hamisi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225360498 PECOS PAC ID: 4385874460 Enrollment ID: I20140312000229 |
| Provider Name | Christine N Emenike-anierobi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922432640 PECOS PAC ID: 8224350475 Enrollment ID: I20141125001945 |
| Provider Name | Patience R Akhimien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346617594 PECOS PAC ID: 8729397773 Enrollment ID: I20151014002230 |
| Provider Name | Loretta J Coakes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073784831 PECOS PAC ID: 2961711684 Enrollment ID: I20151020002940 |
| Provider Name | Mary Edem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760787030 PECOS PAC ID: 9830491737 Enrollment ID: I20160108002574 |
| Provider Name | Shana N Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235598756 PECOS PAC ID: 2163729849 Enrollment ID: I20160323001493 |
| Provider Name | Fady S Boules |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639541022 PECOS PAC ID: 8527356773 Enrollment ID: I20161004002021 |
| Provider Name | Vimal N Satodiya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174879134 PECOS PAC ID: 1254629314 Enrollment ID: I20161005003098 |
| Provider Name | Gloria Sudeta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083070064 PECOS PAC ID: 7810285210 Enrollment ID: I20161130001840 |
| Provider Name | Munjal Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962866624 PECOS PAC ID: 3274814777 Enrollment ID: I20161221000167 |
| Provider Name | Grace Adeagbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992986731 PECOS PAC ID: 2668677402 Enrollment ID: I20170112000909 |
| Provider Name | Jogendra Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174998843 PECOS PAC ID: 3274824354 Enrollment ID: I20170313000975 |
| Provider Name | Linda C Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376071092 PECOS PAC ID: 3870862600 Enrollment ID: I20170710002413 |
| Provider Name | Ashee Amjad Amjad Waryam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760920391 PECOS PAC ID: 8921370255 Enrollment ID: I20170822002762 |
| Provider Name | Madhumalti D Bhavsar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013958867 PECOS PAC ID: 0446221410 Enrollment ID: I20170914002133 |
| Provider Name | Nandita C Puchakayala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720320989 PECOS PAC ID: 5698040665 Enrollment ID: I20171002003233 |
| Provider Name | Sjoekie F Sasbone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609196674 PECOS PAC ID: 4789950312 Enrollment ID: I20171025002498 |
| Provider Name | Deep P Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194247072 PECOS PAC ID: 4880952142 Enrollment ID: I20171215000070 |
| Provider Name | Oluwayemisi O Daramola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215379276 PECOS PAC ID: 4284970005 Enrollment ID: I20190115001742 |
| Provider Name | Chen-ying Wu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144576299 PECOS PAC ID: 6002108586 Enrollment ID: I20190126000048 |
| Provider Name | Neelima Kunam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114269685 PECOS PAC ID: 1052543014 Enrollment ID: I20190311001423 |
| Provider Name | Peter C Shorts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982113676 PECOS PAC ID: 4880935949 Enrollment ID: I20190418000983 |
| Provider Name | Blessing E Umugbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710441449 PECOS PAC ID: 4284976044 Enrollment ID: I20190425002795 |
| Provider Name | Josephine E Aideloje |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790272243 PECOS PAC ID: 7113269986 Enrollment ID: I20190425003122 |
| Provider Name | Paloma Velez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326173055 PECOS PAC ID: 8123360740 Enrollment ID: I20190501002026 |
| Provider Name | Chinyere A Obakhume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134683816 PECOS PAC ID: 9335482975 Enrollment ID: I20190522000752 |
| Provider Name | Jagan Mohan Rao Jakkula |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891924957 PECOS PAC ID: 5193966729 Enrollment ID: I20190627003062 |
| Provider Name | Rachael I Obi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760940001 PECOS PAC ID: 2769717867 Enrollment ID: I20190711001917 |
| Provider Name | Marcos Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235141102 PECOS PAC ID: 3870829245 Enrollment ID: I20190723001261 |
| Provider Name | Chrystanya A Adeniji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760969562 PECOS PAC ID: 5193052678 Enrollment ID: I20190806003140 |
| Provider Name | Tulasi Kanukuntla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306078118 PECOS PAC ID: 4587805122 Enrollment ID: I20190912002872 |
| Provider Name | Racheal E Aneke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073071684 PECOS PAC ID: 3577894492 Enrollment ID: I20191008000857 |
| Provider Name | Linda L Hibbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235466590 PECOS PAC ID: 8628309010 Enrollment ID: I20191016002399 |
| Provider Name | Victoria Dubois |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093185035 PECOS PAC ID: 8628309028 Enrollment ID: I20191016002883 |
| Provider Name | Laura G Delmar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689902496 PECOS PAC ID: 8426389701 Enrollment ID: I20191017002380 |
| Provider Name | Linda Y Chow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164750956 PECOS PAC ID: 7416288626 Enrollment ID: I20191018000846 |
| Provider Name | Christine M Piddington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265953293 PECOS PAC ID: 3870825474 Enrollment ID: I20191031001886 |
| Provider Name | Jules Beuck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255754263 PECOS PAC ID: 8224360607 Enrollment ID: I20191105000439 |
| Provider Name | Rosekate C Ugorji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043481922 PECOS PAC ID: 7911332804 Enrollment ID: I20200123000926 |
| Provider Name | Ngozi Anyanacho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760989834 PECOS PAC ID: 5395172100 Enrollment ID: I20200217001151 |
| Provider Name | Henry D Cabrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245722362 PECOS PAC ID: 9739516964 Enrollment ID: I20200227000965 |
| Provider Name | Adekunle S Adegbite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407494735 PECOS PAC ID: 8123456977 Enrollment ID: I20200310001848 |
| Provider Name | Margaret Waithaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518139336 PECOS PAC ID: 2062834419 Enrollment ID: I20200612001400 |
| Provider Name | Sara Ashley Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083803118 PECOS PAC ID: 3577982065 Enrollment ID: I20201002000203 |
| Provider Name | Lakesha E Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649804469 PECOS PAC ID: 5799195640 Enrollment ID: I20201103002777 |
| Provider Name | Folashade Jayeoba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871192492 PECOS PAC ID: 1759795305 Enrollment ID: I20210122001388 |
| Provider Name | John O Adeniji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003280892 PECOS PAC ID: 7517372386 Enrollment ID: I20210209002299 |
| Provider Name | Adam Brasket |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467072132 PECOS PAC ID: 0840606646 Enrollment ID: I20210302002378 |
| Provider Name | Mazaira Lennon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184895799 PECOS PAC ID: 5597172155 Enrollment ID: I20210325002710 |
| Provider Name | Sandeep Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972910016 PECOS PAC ID: 5597173203 Enrollment ID: I20210419001541 |
| Provider Name | Noja A Nash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386965986 PECOS PAC ID: 8325457401 Enrollment ID: I20210430000447 |
| Provider Name | Vajezatha Payne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558651372 PECOS PAC ID: 4880003698 Enrollment ID: I20210518002584 |
| Provider Name | Chimezie L Igwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891384053 PECOS PAC ID: 5890195432 Enrollment ID: I20210617003077 |
| Provider Name | Pamela D Coleman-snow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992388060 PECOS PAC ID: 0648674887 Enrollment ID: I20210810001510 |
| Provider Name | Tony A Akpengbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437441524 PECOS PAC ID: 8729483797 Enrollment ID: I20210830001541 |
| Provider Name | Jill M Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649421298 PECOS PAC ID: 4981001286 Enrollment ID: I20210929002932 |
| Provider Name | Brandi L Parr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578939013 PECOS PAC ID: 6204234446 Enrollment ID: I20211001002019 |
| Provider Name | Idongesit J Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467964114 PECOS PAC ID: 0244638500 Enrollment ID: I20211018001945 |
| Provider Name | Phebee William |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093276149 PECOS PAC ID: 2668700675 Enrollment ID: I20211108001454 |
| Provider Name | Alfred D Belen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386776847 PECOS PAC ID: 5597810499 Enrollment ID: I20211210000669 |
| Provider Name | Janet Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013677145 PECOS PAC ID: 9537551601 Enrollment ID: I20220121002142 |
| Provider Name | Maricela T Beltran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699204321 PECOS PAC ID: 1254724685 Enrollment ID: I20220208001992 |
| Provider Name | Eberechi Ani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801332051 PECOS PAC ID: 7517350812 Enrollment ID: I20220209001993 |
| Provider Name | Abraham Nunez Tellez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700068319 PECOS PAC ID: 7416347372 Enrollment ID: I20220323001978 |
| Provider Name | Kenneth Ezenwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003379959 PECOS PAC ID: 1951788215 Enrollment ID: I20220506002213 |
| Provider Name | Lovelyn U Anyanwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861141327 PECOS PAC ID: 5890172951 Enrollment ID: I20220511002688 |
| Provider Name | Cirsten Brinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932535812 PECOS PAC ID: 0345627394 Enrollment ID: I20220513001095 |
| Provider Name | Beatrice I Okonkwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558019984 PECOS PAC ID: 9234516998 Enrollment ID: I20220518001502 |
| Provider Name | Ndubuisi Chimezie Obioha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699410746 PECOS PAC ID: 3375923915 Enrollment ID: I20220629001582 |
| Provider Name | Lindsey E Hersh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093281453 PECOS PAC ID: 4981085578 Enrollment ID: I20220713002714 |
| Provider Name | Abiodun Toriola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235862780 PECOS PAC ID: 5698158244 Enrollment ID: I20220816000357 |
| Provider Name | Simone N Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811133986 PECOS PAC ID: 2062895519 Enrollment ID: I20220816000723 |
| Provider Name | Valoria Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790933398 PECOS PAC ID: 2961885439 Enrollment ID: I20220816001638 |
| Provider Name | Cindy S Ordonez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417618547 PECOS PAC ID: 5991189508 Enrollment ID: I20220831001994 |
| Provider Name | Israel Valdez-hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073842662 PECOS PAC ID: 0446635718 Enrollment ID: I20220922002381 |
| Provider Name | Magnus C Ihemedu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649628322 PECOS PAC ID: 2668848763 Enrollment ID: I20221014000479 |
| Provider Name | Chika Q Ugwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760113195 PECOS PAC ID: 9537536842 Enrollment ID: I20221028002499 |
| Provider Name | Alexis V Ventura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609410463 PECOS PAC ID: 7012384076 Enrollment ID: I20221103001342 |
| Provider Name | Thang V Pham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841457033 PECOS PAC ID: 3476920471 Enrollment ID: I20221103002981 |
| Provider Name | Amarachi C Ihemedu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992309561 PECOS PAC ID: 2567831183 Enrollment ID: I20221202002257 |
| Provider Name | Chinwe Anuforo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063148419 PECOS PAC ID: 3375913908 Enrollment ID: I20221222002804 |
| Provider Name | Abigail Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962127795 PECOS PAC ID: 9133591647 Enrollment ID: I20230209002261 |
| Provider Name | Marcia E Bernard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346421328 PECOS PAC ID: 1658504303 Enrollment ID: I20230328002892 |
| Provider Name | Haya Alsarhn Bahbah |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609497130 PECOS PAC ID: 3678938503 Enrollment ID: I20230428001505 |
| Provider Name | Mayowa Adesina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669170528 PECOS PAC ID: 3072979947 Enrollment ID: I20230518001963 |
| Provider Name | Justina Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487351748 PECOS PAC ID: 9931481744 Enrollment ID: I20230530001985 |
| Provider Name | Daniel Contreras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174134951 PECOS PAC ID: 9638537111 Enrollment ID: I20230614003931 |
| Provider Name | Elizabeth Anyanwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740526730 PECOS PAC ID: 6103284450 Enrollment ID: I20230620001574 |
| Provider Name | Omorogiuwa Adeneye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770271280 PECOS PAC ID: 9436519279 Enrollment ID: I20230712002229 |
| Provider Name | Brent T Louie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245897990 PECOS PAC ID: 4981082815 Enrollment ID: I20230808002938 |
| Provider Name | Sean Bayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992495113 PECOS PAC ID: 2264894658 Enrollment ID: I20230817000073 |
| Provider Name | Mario Vega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275213332 PECOS PAC ID: 4981058914 Enrollment ID: I20230926000696 |
| Provider Name | Mansi Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134875180 PECOS PAC ID: 8628423498 Enrollment ID: I20231013002145 |
| Provider Name | Brooke Hardge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407511587 PECOS PAC ID: 3072961051 Enrollment ID: I20231201000559 |
| Provider Name | Samuel A Amoako |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245579879 PECOS PAC ID: 5799134565 Enrollment ID: I20231206001028 |
| Provider Name | Kenneth G Webb |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972689826 PECOS PAC ID: 0042660680 Enrollment ID: I20231222001951 |
| Provider Name | Faye E Herrmann |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558404186 PECOS PAC ID: 6204287113 Enrollment ID: I20240104003165 |
| Provider Name | Ezinwanyi G Mark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780374900 PECOS PAC ID: 6103277637 Enrollment ID: I20240109004844 |
| Provider Name | Newton Agrawal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023376936 PECOS PAC ID: 3274862826 Enrollment ID: I20240115001851 |
| Provider Name | Kristina Hanson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265745855 PECOS PAC ID: 6800249350 Enrollment ID: I20240131002817 |
| Provider Name | Amanda L Dehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851749881 PECOS PAC ID: 5698110153 Enrollment ID: I20240223003979 |
| Provider Name | Kim N Phan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245327071 PECOS PAC ID: 1557706439 Enrollment ID: I20240301000834 |
| Provider Name | Moises Ponce |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1760508774 PECOS PAC ID: 7517302326 Enrollment ID: I20240304000772 |
South Coast Community Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1030 Nevada St Ste 200, Redlands, CA 92374 Phone: 909-792-0474 | |
Changeful Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 9th St Ste 100-173, Redlands, CA 92374 Phone: 909-654-5992 | |
San Bernardino County Superintendent Of Schools Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1812 W Park Ave, Redlands, CA 92373 Phone: 909-748-0259 | |
Inlandpsych Redlands Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 255 Terracina Blvd, Suite 204, Redlands, CA 92373 Phone: 909-798-1763 | |
Creative Change Therapy Center, A Clinical Social Worker Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1255 W Colton Ave # 614, Redlands, CA 92374 Phone: 760-699-4199 | |
Cross Cultural Mft Counseling Center, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 535 W State St, Suite # C, Redlands, CA 92373 Phone: 562-522-8008 Fax: 909-335-5991 | |
Thomas Psychology Group Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1221 Calle De Barranca, Redlands, CA 92373 Phone: 909-255-2860 Fax: 909-796-0027 |