Southern California Psychiatric Group, Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

SOUTHERN CALIFORNIA PSYCHIATRIC GROUP, INC

Practice address

28125 Bradley Rd Ste 220
Sun City, CA 92586-2288

Phone

(951) 309-2140

Fax

(951) 309-2141

NPI assigned

Oct 29, 2019

Last updated

May 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bhuvaneswari Nallamothu, MDNPI 1063542140

Title

President

Phone

(951) 309-2140

Specialties & licenses 5

Addresses

Tax ID family

Southern California Psychiatric Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southern California Psychiatric Group, Inc

  • Child & Adolescent Psychiatry Physician
  • Sun City, CA
  • NPI 1285951871
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bhuvaneswari Nallamothu, M.D.

  • Child & Adolescent Psychiatry Physician
  • Sun City, CA
  • NPI 1063542140
  NPD (past) Authorized official

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590192000000",
    "number": "1033753470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28125 BRADLEY RD STE 220",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862288",
            "telephone_number": "800-519-7274",
            "fax_number": "951-309-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28125 BRADLEY RD STE 220",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862288",
            "telephone_number": "951-309-2140",
            "fax_number": "951-309-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA PSYCHIATRIC GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2020-05-23",
        "certification_date": "2020-05-23",
        "status": "A",
        "authorized_official_last_name": "NALLAMOTHU",
        "authorized_official_first_name": "BHUVANESWARI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-309-2140",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Sun City, CA
• Providers in Sun City, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2020; 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.