Pituck Medical Group, Inc.

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

Legal business name

PITUCK MEDICAL GROUP, INC.

Practice address

5858 Magnolia Ave Ste C
Riverside, CA 92506-1886

Phone

(714) 223-0396

Fax

(714) 223-0397

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Michele Severson

Title

Administrator

Phone

(714) 223-0396

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Roger Delgado, PH.D

  • Clinical Social Worker
  • Fontana, CA
  • NPI 1407997497
  NPD (past)
• Faye Denise Owen, M.D.

  • Psychiatry Physician
  • Patton, CA
  • NPI 1497707293
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1255544557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 SOMERSET DR",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928702025",
            "telephone_number": "714-223-0396",
            "fax_number": "714-223-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5858 MAGNOLIA AVE STE C",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061886",
            "telephone_number": "714-223-0396",
            "fax_number": "714-223-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITUCK MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "SEVERSON",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "714-223-0396"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Pistone, RN
• Nayely Pita
• Graysen Ursus Pitcher
• Alessandra Pitco, MD
• Ashley Francine Pitts, MS
• Lourdes Placensia
• Yajaira Placensia
• Planned Parenthood of the Pacific Southwest
• Maria Guadalupe Plascencia Mercado
• Esmeralda Alcantar Plascencia, MSW

• Prescribing (Medical) Psychologist in Riverside, CA
• Providers in Riverside, CA by specialty
• Prescribing (Medical) Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.