Individual provider Active NPI

Melissa Joy Pereau, M.D.

  • Psychiatry Physician
  • Loma Linda, CA
National Provider Identifier
1457568818
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A93340 Issued in CA
Practice address
11201 Benton St
Loma Linda, CA 92357-2804
Phone
(909) 825-7084
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A93340 CA Primary

Addresses

Primary practice location

11201 Benton St
Loma Linda, CA 92357-2804

Mailing address

PO Box 2302
Redlands, CA 92373-0781

Other practice location 1

3950 Reynolds Rd
Riverside, CA 92503-3517
Phone (951) 358-4466

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080924000470 CA Practitioner - Psychiatry 9537236161 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Psychiatry PC Psychiatry Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 7, 2008 Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Aug 1, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm Psychiatry CurrentSince Jul 7, 2008 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Aug 1, 2023 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

11234 Anderson St
Ofc Cp
Loma Linda, CA 92350
Phone 9095584000 ext. 88131

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

Organizations & group practices 6

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1457568818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2302",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923572804",
            "telephone_number": "909-825-7084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3950 Reynolds Rd",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033517",
            "country_code": "US",
            "telephone_number": "951-358-4466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREAU",
        "first_name": "MELISSA",
        "middle_name": "JOY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A93340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.