Richard Gabriel Samedra, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95030301 Issued in CA

Practice address

1720 W Ball Rd Ste 4C
Anaheim, CA 92804-5591

Phone

(714) 683-1472

Fax

(714) 683-1473

NPI assigned

Apr 30, 2024

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Coast Medical P CGroup PAC ID 2062951205, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Coast Medical, PC

  dba Orange Coast Psychiatry

  • Psychiatry Physician
  • Anaheim, CA
  • NPI 1780435628

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Mental Health and Nursing PC

  dba Renewed Mental Health Group

  • Psychiatric/Mental Health Nurse Practitioner
  • Anaheim, CA
  • NPI 1528693579
  Medicare reassignment NPD
• Renewed Medical Group, a Professional Medical Corporation

  dba Renewed Mental Health and Wellness Group

  • Psychiatry Physician
  • Anaheim, CA
  • NPI 1922785690

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1093561904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 ORANGE GROVE AVE",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928704848",
            "telephone_number": "949-566-4308",
            "fax_number": "714-683-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 W BALL RD STE 4C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928045591",
            "telephone_number": "714-683-1472",
            "fax_number": "714-683-1473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Orange Grove Ave",
            "address_purpose": "LOCATION",
            "city": "Placentia",
            "state": "CA",
            "postal_code": "928704848",
            "country_code": "US",
            "telephone_number": "949-566-4308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMEDRA",
        "first_name": "RICHARD",
        "middle_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-30",
        "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": "95030301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haidy Samaan
• Arely Samano
• Samara Palacio Cardenas M.D. a Professional Corporation
• Samaritan Ambulance Inc
• Farmata Samati
• John Samimi, PHARM.D.
• Sam A. Samimi, M.D.
• Samir Azzam MD Inc
• Jacquelyn Diane Sammons, D.O.
• Sheryl G Samperisi

• Psychiatric/Mental Health Nurse Practitioner in Anaheim, CA
• Providers in Anaheim, 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.