NPIMap

Organization Active NPI

Riverside Unversity Behavioral Health

  • Adult Mental Health Clinic/Center
  • Perris, CA
National Provider Identifier
1013424522
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
RIVERSIDE UNVERSITY BEHAVIORAL HEALTH
Practice address
1688 N Perris Blvd Ste L6-11
Perris, CA 92571-4709
Phone
(951) 443-2200
Fax
(951) 443-2230
NPI assigned
Jan 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Thaddeus A Wicki, MFT
Title
Supervisor
Phone
(951) 443-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1688 N Perris Blvd Ste L6-11
Perris, CA 92571-4709

Mailing address

1688 N Perris Blvd Ste L6-11
Perris, CA 92571-4709
Phone (951) 443-2200

Other identifiers 1

IdentifierTypeStateIssuer
101YM0800XMedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515110400000",
    "number": "1013424522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1688 N PERRIS BLVD STE L6-11",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925714709",
            "telephone_number": "951-443-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1688 N PERRIS BLVD STE L6-11",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925714709",
            "telephone_number": "951-443-2200",
            "fax_number": "951-443-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE UNVERSITY BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-01-05",
        "status": "A",
        "authorized_official_last_name": "WICKI",
        "authorized_official_first_name": "THADDEUS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "951-443-2200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YM0800X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perris, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.