NPIMap

Organization Active NPI

County of Riverside

Doing business as Health & Wellness Lifestyle Clinic

  • Community/Behavioral Health Agency
  • Riverside, CA
National Provider Identifier
1356759443
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF RIVERSIDE
Doing business as
Health & Wellness Lifestyle Clinic
Practice address
761 Blaine Street
Riverside, CA 92507-3970
Phone
(951) 358-4705
NPI assigned
Aug 1, 2014
Last updated
Sep 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Authorized official

Name
Dr. Matthew Chang
Title
Director Ruhs - Behavioral Health
Phone
(951) 358-4500

Specialties & licenses 1

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

Addresses

Primary practice location

761 Blaine Street
Riverside, CA 92507-3970

Mailing address

4095 County Circle Dr
Riverside, CA 92503-3410
Phone (951) 358-6900

Other identifiers 1

IdentifierTypeStateIssuer
00033OtherCALEGAL ENTITY

Other names 1

  • Health & Wellness Lifestyle Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Riverside County Mental Health Department245 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

761 W Blaine St
Riverside, CA 92507
Phone (951) 358-4705

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1356759443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4095 COUNTY CIRCLE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033410",
            "telephone_number": "951-358-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 BLAINE STREET",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925073970",
            "telephone_number": "951-358-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF RIVERSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-01",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR RUHS - BEHAVIORAL HEALTH",
        "authorized_official_telephone_number": "951-358-4500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGAL ENTITY",
            "identifier": "00033",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health & Wellness Lifestyle Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Health & Wellness Lifestyle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.