Psychological and Substance Abuse Services, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PSYCHOLOGICAL AND SUBSTANCE ABUSE SERVICES, INC

Practice address

21250 Box Springs Rd Ste 201
Moreno Valley, CA 92557-8712

Phone

(951) 335-5858

Fax

(951) 335-5870

NPI assigned

Mar 29, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Ta Tanisha Jones, PSY.D.NPI 1184112179

Title

Licensed Psychologist, Director

Phone

(951) 505-4234

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Ta Tanisha Jones, PSYD

  • Clinical Psychologist
  • Moreno Valley, CA
  • NPI 1184112179
  Medicare reassignment NPD Authorized official
• Leia Nicole Aguilar

  • Clinical Social Worker
  • Moreno Valley, CA
  • NPI 1295661593
  NPD (past)

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1073074209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6185 MAGNOLIA AVE",
            "address_2": "#224",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21250 BOX SPRINGS RD STE 201",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925578712",
            "telephone_number": "951-335-5858",
            "fax_number": "951-335-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL AND SUBSTANCE ABUSE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TA TANISHA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST, DIRECTOR",
        "authorized_official_telephone_number": "951-505-4234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visith Priromprintr, MD
• Dennis Propp, MD
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• PS Medical Supplies Inc
• Raquel Puebla, LCSW
• Ramya Santhoshi Pulakhandam
• Leroy Pulido
• Cynthia Marie Pulsha, CNM
• Ruben Dauglas Punsalan

• Clinical Psychologist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.