NPIMap

Organization Active NPI

County of Riverside

  • Community/Behavioral Health Agency
  • Moreno Valley, CA
National Provider Identifier
1194890541
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF RIVERSIDE
Practice address
23119 Cottonwood Ave
BLDG a 110
Moreno Valley, CA 92553-9661
Phone
(951) 413-5678
Fax
(951) 413-5660
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Authorized official

Name
Dr. Matthew Chang
Title
Director, Dept. of Mental Health
Phone
(951) 358-4501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

23119 Cottonwood Ave
BLDG a 110
Moreno Valley, CA 92553-9661

Mailing address

PO Box 7549
Riverside, CA 92513-7549
Phone (951) 358-6900

Other identifiers 1

IdentifierTypeStateIssuer
33AHMedicaidCA

Other names 1

  • MORENO VALLEY CHILDREN'S INTERAGENCY PROGRAM Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310001107 CA Part B Supplier - Clinic/Group Practice 6507754488 Receives reassigned benefits from 362 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Riverside County Dept244 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

23119 Cottonwood Ave
Ste A110
Moreno Valley, CA 92553
Phone (951) 413-5627

Practitioners & affiliated clinicians

Practitioners 8

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": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1194890541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7549",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925137549",
            "telephone_number": "951-358-6900",
            "fax_number": "951-358-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23119 COTTONWOOD AVE",
            "address_2": "BLDG A 110",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925539661",
            "telephone_number": "951-413-5678",
            "fax_number": "951-413-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF RIVERSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR, DEPT. OF MENTAL HEALTH",
        "authorized_official_telephone_number": "951-358-4501",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33AH",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MORENO VALLEY CHILDREN'S INTERAGENCY PROGRAM",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MORENO VALLEY CHILDREN'S INTERAGENCY PROGRAM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.