NPIMap

Organization Active NPI

Ucr Health Psychiatry - Brockton

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Riverside, CA
National Provider Identifier
1568852473
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
UCR HEALTH PSYCHIATRY - BROCKTON
Practice address
5887 Brockton Ave
Suite a
Riverside, CA 92506-1853
Phone
(951) 827-7961
Fax
(951) 530-4783
NPI assigned
Jan 29, 2015
Organization subpart
Yes
Parent organization
REGENTS OF UNIVERSITY OF CALIFORNIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Authorized official

Name
John A. Heydt, MD
Title
Chief Executive Officer
Phone
(714) 456-2986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

5887 Brockton Ave
Suite a
Riverside, CA 92506-1853

Mailing address

PO Box 31001-2130
Pasadena, CA 91110-2130
Phone (213) 412-1973

National Provider Directory

National Provider Directory
Tax ID family
Arlington Gardens Care Center30 organizations share this tax ID, including this one
Part of
Regents of the University of California

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1568852473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-2130",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911102130",
            "telephone_number": "213-412-1973",
            "fax_number": "213-412-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5887 BROCKTON AVE",
            "address_2": "SUITE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061853",
            "telephone_number": "951-827-7961",
            "fax_number": "951-530-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCR HEALTH PSYCHIATRY - BROCKTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF UNIVERSITY OF CALIFORNIA",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "HEYDT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-456-2986",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 29, 2015; 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.