Breakthrough Psychology Group PC
Organization Active NPI Clinical Child & Adolescent Psychologist · Eastvale, CA
NPI 1457095986 · NPPES record last updated Feb 26, 2026
Key facts
- NPI
- 1457095986
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Child & Adolescent Psychologist 103TC2200X
- Legal business name
- BREAKTHROUGH PSYCHOLOGY GROUP PC
- Practice address
- 7346 Sungold Ave
Eastvale, CA 92880-9031 - Phone
- (909) 276-7720
- NPI assigned
- Apr 21, 2022
- Organization subpart
- No
Authorized official
- Name
- Jared A Doegey
- Title
- Owner
- Phone
- (909) 276-7720
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220518002901 | CA | Part B Supplier - Clinic/Group Practice | 3577940279 |
Receives reassigned benefits from 1 practitioner Practice locations: Eastvale, CA |
| O20260324000054 | TN | Part B Supplier - Clinic/Group Practice | 3577940279 |
Receives reassigned benefits from 1 practitioner Practice locations: White House, TN |
National Provider Directory
Locations
18102 Pioneer Blvd
Ste 103
Artesia, CA 90701
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist |
103TC2200X | Yes | ||
| Group Psychotherapy Psychologist |
103TP2701X | |||
| Clinical Social Worker |
1041C0700X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
7346 Sungold Ave
Eastvale, CA 92880-9031
Mailing address
7346 Sungold Ave
Eastvale, CA 92880-9031
Phone (909) 276-7720
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.