| Clint Levis Ngassem, | |
|
11162 Palm Terrace Ln, Riverside, CA 92505-2338 | |
| (951) 687-7330 | |
| Not Available |
| Full Name | Clint Levis Ngassem |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 1 Years |
| Location | 11162 Palm Terrace Ln, Riverside, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043006711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 95034752 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Jason Kellogg Md Inc | 9032266127 | 19 |
| Entity Name | Jason Kellogg MD Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235391624 PECOS PAC ID: 9032266127 Enrollment ID: O20090407000131 |
| Entity Name | Real Road Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134688674 PECOS PAC ID: 1052858396 Enrollment ID: O20240803000460 |
| Mailing Address | Practice Location Address |
|---|---|
| Clint Levis Ngassem, 1699 E Washington St Apt 2174, Colton, CA 92324-4699 Ph: (909) 780-5399 | Clint Levis Ngassem, 11162 Palm Terrace Ln, Riverside, CA 92505-2338 Ph: (951) 687-7330 |
Alice Chinyere Echeta, FNP, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4960 Arlington Ave Ste B, Riverside, CA 92504 Phone: 951-341-8930 |
Obianuju Rivera, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3801 University Ave Ste 270, Riverside, CA 92501 Phone: 855-427-2778 Fax: 951-530-3997 |
Luamy Gabriela Cornejo, PNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4440 Brockton Ave Ste 100, Riverside, CA 92501 Phone: 951-684-1293 |
Christine Pham Duong, DNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5549 Van Buren Blvd, Riverside, CA 92503 Phone: 951-324-5901 Fax: 877-778-9472 |
Namrata Nicole Sihotang, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 19330 Jesse Ln Ste 100, Riverside, CA 92508 Phone: 844-827-8000 |
Maiying Her, CPNP-PC Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 2933 University Ave, Riverside, CA 92507 Phone: 951-224-8220 |
Liliana Amaya, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3419 Eucalyptus Ave, Riverside, CA 92507 Phone: 951-218-4016 |