Marcella Natasha Kordus-Salonen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

18501 Issued in CA

Practice address

5051 Canyon Crest Dr
Riverside, CA 92507-6096

Phone

(951) 682-1488

NPI assigned

Aug 23, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Collaborative Psychology Group a Professional CorporationGroup PAC ID 9436494671, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Collaborative Psychology Group, a Professional Corporation

  • Clinical Psychologist
  • Riverside, CA
  • NPI 1336532340
  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1285281147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6066 SAINT AUGUSTINE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063767",
            "telephone_number": "951-323-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5051 CANYON CREST DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076096",
            "telephone_number": "951-682-1488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41760 Ivy St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925629416",
            "country_code": "US",
            "telephone_number": "951-698-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORDUS-SALONEN",
        "first_name": "MARCELLA",
        "middle_name": "NATASHA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "18501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.collaborativepsychgroup.com",
            "affiliation": "N",
            "endpointDescription": "private practice",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5051 Canyon Crest Dr",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925076096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Daniel Koontz, MD
• Juan Carlo Koontz
• Analira Koopman
• Truazul P Korazonazul
• Vivekanand Korde, CIP
• Doris R Kore, DDS
• Joshua Michael Korhely
• Rebecca Kornbluth
• Ralph A Korpman, M.D.
• Brianne Marie Korta

• Clinical Psychologist in Riverside, CA
• Providers in Riverside, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.