Integrated Mind Institute

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

A97080 Issued in CA

Legal business name

INTEGRATED MIND INSTITUTE

Practice address

24949 Prospect Ave
Loma Linda, CA 92354-2811

Phone

(909) 796-4774

Fax

(909) 796-2774

NPI assigned

Jun 3, 2009

Last updated

Mar 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Warris Richard Walayat Sr., M.D.

Title

Chairman

Phone

(909) 796-4774

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1306072426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24550 LAWTON AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543336",
            "telephone_number": "909-796-4774",
            "fax_number": "909-796-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24949 PROSPECT AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542811",
            "telephone_number": "909-796-4774",
            "fax_number": "909-796-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MIND INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "WALAYAT",
        "authorized_official_first_name": "WARRIS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "909-796-4774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CA",
            "license": "A97080",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A97080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A970800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inland Psychiatric Medical Group Inc
• Inland Temporary Homes (Inland Housing Solutions)
• Jared Christian Inman, M.D.
• Nobuaki Inoue, MD
• Integrated Care Response
• Integrated Mind, Inc. (Child and Family Center)
• Cristian M Iordan
• Daniel Ip, DDS
• Daniel Iracheta, PA-C
• Meher Rustom Irani, MD

• Adolescent and Children Mental Health Clinic/Center in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Adolescent and Children Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.