Radiant Mind Neuro and Psychology Clinic Inc

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

RADIANT MIND NEURO AND PSYCHOLOGY CLINIC INC

Practice address

402 W Broadway Ste 400
San Diego, CA 92101-3554

Phone

(619) 595-3100

NPI assigned

Mar 24, 2025

Organization subpart

No

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

Authorized official

Name

Melissa Rios, PSY.DNPI 1093290926

Title

Owner

Phone

(424) 248-7139

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa Rios, PSYD

  • Clinical Psychologist
  • Granada Hills, CA
  • NPI 1093290926
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1629879721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 MCLEOD DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891212257",
            "telephone_number": "424-248-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W BROADWAY STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013554",
            "telephone_number": "619-595-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3225 McLeod Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891212257",
            "country_code": "US",
            "telephone_number": "424-248-7139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RADIANT MIND NEURO AND PSYCHOLOGY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-08-20",
        "certification_date": "2025-07-21",
        "status": "A",
        "authorized_official_last_name": "RIOS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "424-248-7139",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.

Verify at the official NPI Registry.