Active NPI
County of Riverside
Doing business as San Jacinto Mental Health
- Community/Behavioral Health Agency
- San Jacinto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- COUNTY OF RIVERSIDE
- Doing business as
- San Jacinto Mental Health
- Practice address
- 950 N Ramona Blvd
Suites 1-3
San Jacinto, CA 92582-2567 - Phone
- (951) 487-2674
- Fax
- (951) 487-2679
- NPI assigned
- Nov 21, 2006
- Last updated
- Sep 9, 2022
- Organization subpart
- No
NPPES NPI Registry
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) 358-4501
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
950 N Ramona Blvd
Suites 1-3
San Jacinto, CA 92582-2567
Mailing address
PO Box 7549
Riverside, CA 92513-7549
Phone (951) 358-6900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33CS | Medicaid | CA |
Other names 1
- SAN JACINTO MENTAL HEALTH
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040310001107 | CA | Part B Supplier - Clinic/Group Practice | 6507754488 |
Receives reassigned benefits from 362 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Tax ID family
- Riverside County Mental Health Department
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.
-
- Local Education Agency (LEA)
- Riverside, CA
- NPI 1417139825
-
dba Health & Wellness Lifestyle Clinic
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1356759443
-
dba Children's Emergency Screening Unit
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1386719235
-
dba Banning MCMT
- Community/Behavioral Health Agency
- Cherry Valley, CA
- NPI 1396467023
-
dba MHSA MDFT West Expansion
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1407016769
-
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1407154537
-
dba Children's Wraparound
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1407921356
-
dba Windy Springs Wellness Center
- Community/Behavioral Health Agency
- Palm Springs, CA
- NPI 1417197963
-
dba Juvenile Hall-YOP Riverside
- Community/Behavioral Health Agency
- Riverside, CA
- NPI 1417299694
-
dba New Life SU - Indio Probation
- Community/Behavioral Health Agency
- Indio, CA
- NPI 1417320060
-
dba New Life SU - Perris Probation
- Community/Behavioral Health Agency
- Perris, CA
- NPI 1417328089
Locations
950 N Ramona Blvd
Ste 13
San Jacinto, CA 92582
Phone (951) 487-2674
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1662681600000",
"number": "1407921877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7549",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925137549",
"telephone_number": "951-358-6900",
"fax_number": "951-358-6905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 N RAMONA BLVD",
"address_2": "SUITES 1-3",
"city": "SAN JACINTO",
"state": "CA",
"postal_code": "925822567",
"telephone_number": "951-487-2674",
"fax_number": "951-487-2679"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF RIVERSIDE",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-21",
"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": "951-358-4501",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33CS",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SAN JACINTO MENTAL HEALTH",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "SAN JACINTO MENTAL HEALTH",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in San Jacinto, CA
- Staphany Gabriela Alvarez Cortez, PPS
- Wayne Cortez
- Shamarjee S Cosby
- County of Riverside (San Jacinto SAPT)
- County of Riverside (MHSA FSP SMART-Mid County)
- County of Riverside (MHSA PEI-PEARLS Mid-Co)
- County of Riverside
- County of Riverside (New Life SU - Hemet Probation)
- County of Riverside (Hemet New Life MH Probation)
- Covenant Healthcare, LLC
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.