Clint Levis Ngassem

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95034752 Issued in CA

Practice address

11162 Palm Terrace LN
Riverside, CA 92505-2338

Phone

(951) 687-7330

NPI assigned

Apr 17, 2025

Last updated

Apr 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jason Kellogg MD IncGroup PAC ID 9032266127, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jason Kellogg M.D. Inc

  dba Progeny Psychiatric Group

  • Psychiatry Physician
  • Newport Beach, CA
  • NPI 1235391624
  Medicare reassignment Care Compare group NPD
• Healing Solutions Family Therapy Center Inc.

  dba Healing Solutions Family Therapy Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lancaster, CA
  • NPI 1134688674
  Medicare reassignment

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1043006711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 E WASHINGTON ST APT 2174",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244699",
            "telephone_number": "909-780-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11162 PALM TERRACE LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925052338",
            "telephone_number": "951-687-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGASSEM",
        "first_name": "CLINT",
        "middle_name": "LEVIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95034752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel NG, MD
• Iris Yun-CHI NG, PT
• Tina T NG, M.D.
• Paul Nganga, RN
• Priscilla Ngantung
• Mispa Ngo Momnougui
• Linh N. Ngo-Reyes, MPT
• Curtis Ngo
• Gerald Anh Ngo, MD
• Julie Tuyet Nhi Ngo

• Psychiatric/Mental Health Nurse Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.