Individual provider Active NPI

Camille Suzanne Reineke, PHD

  • Psychologist
  • Riverside, CA
National Provider Identifier
1336243401
Registry record updated Mar 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY18079 Issued in CA
Practice address
6809 Indiana Ave Ste 140
Riverside, CA 92506-4221
Phone
(951) 633-9270
Fax
(951) 210-7275
NPI assigned
Sep 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY18079 CA Primary

Addresses

Primary practice location

6809 Indiana Ave Ste 140
Riverside, CA 92506-4221

Mailing address

6809 Indiana Ave Ste 140
Riverside, CA 92506-4221
Phone (951) 633-9270

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20031222000904 CA Practitioner - Clinical Psychologist 5395643761 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians
Riverside Psychiatric Medical GroupGroup PAC ID 8426956954, 8 clinicians

Practice addresses (Care Compare)

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

5887 Brockton Ave
Suite a
Riverside, CA 92506-1858
Phone (951) 275-8500

6809 Indiana Ave
Suite 140
Riverside, CA 92506-4221
Phone (951) 633-9270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY18079CAMDPsychologist
18079CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Psychiatric Medical Group CurrentSince Nov 1, 2003 Accepting new patients
Camille S Reineke Psychology Consulting Professional Corporatio CurrentSince Sep 22, 2025 Accepting new patients
Sud Specialty Group - Ca CurrentSince May 1, 2025 Accepting new patients

Locations

5887 Brockton Ave
Ste A
Riverside, CA 92506
Phone (909) 275-8500

6809 Indiana Ave
Ste 140
Riverside, CA 92506
Phone (530) 273-1112

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772323200000",
    "number": "1336243401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 INDIANA AVE STE 140",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064221",
            "telephone_number": "951-633-9270",
            "fax_number": "951-210-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6809 INDIANA AVE STE 140",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064221",
            "telephone_number": "951-633-9270",
            "fax_number": "951-210-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINEKE",
        "first_name": "CAMILLE",
        "middle_name": "SUZANNE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2026-03-01",
        "certification_date": "2026-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY18079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.