Individual provider Active NPI

Caroline Chinonye Peters, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1659153930
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95001000 Issued in CA
Practice address
8990 Garfield St Ste 6
Riverside, CA 92503-3922
Phone
(909) 587-7248
NPI assigned
Oct 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95001000 CA Primary

Addresses

Primary practice location

8990 Garfield St Ste 6
Riverside, CA 92503-3922

Mailing address

7989 Koa Wood CT
Eastvale, CA 92880-3522
Phone (951) 332-1981

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241125004022 CA Practitioner - Nurse Practitioner 9335674548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wholesome Psychiatry and Medical Services IncGroup PAC ID 8123559119, 2 clinicians

Practice addresses (Care Compare)

1611 Pomona Rd
Suite 109
Corona, CA 92878-4324
Phone (909) 966-5678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wholesome Psychiatry and Medical Services Inc CurrentSince Sep 21, 2024 Accepting new patients

Locations

1611 Pomona Rd
#109
Corona, CA 92878
Phone (909) 966-5678

1611 Pomona Rd
Ste 109
Corona, CA 92878

Organizations & group practices 1

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": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1659153930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7989 KOA WOOD CT",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928803522",
            "telephone_number": "951-332-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 GARFIELD ST STE 6",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033922",
            "telephone_number": "909-587-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CAROLINE",
        "middle_name": "CHINONYE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95001000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.