Magnolia Psychological Assessment & Therapy Center, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MAGNOLIA PSYCHOLOGICAL ASSESSMENT & THERAPY CENTER, PC

Practice address

12021 Jacaranda Ave Ste 201E
Hesperia, CA 92345-4978

Phone

(760) 454-6817

NPI assigned

Jul 15, 2024

Organization subpart

No

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

Authorized official

Name

Rita OgunlanaNPI 1730752395

Title

Owner

Phone

(760) 454-6817

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Rita A. Ogunlana, PSY.D

  • Clinical Psychologist
  • Victorville, CA
  • NPI 1730752395
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1043057177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12021 JACARANDA AVE STE 201E",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923454978",
            "telephone_number": "760-454-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 JACARANDA AVE STE 201E",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923454978",
            "telephone_number": "760-454-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PSYCHOLOGICAL ASSESSMENT & THERAPY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "OGUNLANA",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-454-6817"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luis Luviano
• Luxottica of America Inc (Target Optical #4469)
• Jodian Natalia Lyn
• Alexandria Macdonald
• Jennifer Pamela Magana
• Tiffanie Mailey, LCSW
• Michael A. Mann, RRT
• Tarence R Mann
• Kimberly Manzo
• Maria Barnes

• Clinical Psychologist in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.