NPIMap

Organization Active NPI

E&T Behavioral Advisory

  • Child & Adolescent Psychiatry Physician
  • San Jacinto, CA
National Provider Identifier
1083983944
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A89851 Issued in CA
Legal business name
E&T BEHAVIORAL ADVISORY
Practice address
950 N Ramona Blvd
Suite 2
San Jacinto, CA 92582-2567
Phone
(718) 551-1378
Fax
(951) 487-2679
NPI assigned
Dec 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Authorized official

Name
Mehran Motamed, M.D.NPI 1053415182
Title
Psychiatrist
Phone
(718) 551-1378

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X A89851 CA Primary

Addresses

Primary practice location

950 N Ramona Blvd
Suite 2
San Jacinto, CA 92582-2567

Mailing address

31086 Larchwood St
Menifee, CA 92584-8702
Phone (718) 551-1378

National Provider Directory

National Provider Directory

Locations

12 N Main St
Ste 10
West Hartford, CT 06107
Phone (845) 542-3345

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": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481241600000",
    "number": "1083983944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31086 LARCHWOOD ST",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925848702",
            "telephone_number": "718-551-1378",
            "fax_number": "718-551-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N RAMONA BLVD",
            "address_2": "SUITE 2",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925822567",
            "telephone_number": "718-551-1378",
            "fax_number": "951-487-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E&T BEHAVIORAL ADVISORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2016-12-09",
        "status": "A",
        "authorized_official_last_name": "MOTAMED",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "718-551-1378",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A89851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.