NPIMap

Organization Active NPI

Riverside County Mental Health Dept.

Doing business as Perris Family Room Clinic

  • Mental Health Counselor
  • Perris, CA
National Provider Identifier
1700328929
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RIVERSIDE COUNTY MENTAL HEALTH DEPT.
Doing business as
Perris Family Room Clinic
Practice address
1688 N Perris Blvd
Suite L6-11
Perris, CA 92571
Phone
(951) 443-2200
Fax
(951) 443-2230
NPI assigned
Nov 7, 2016
Last updated
Nov 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Authorized official

Name
Anthony Wicki
Title
BH MFT/Supervisor
Phone
(951) 443-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

1688 N Perris Blvd
Suite L6-11
Perris, CA 92571

Mailing address

1688 N Perris Blvd
Suite L6-11
Perris, CA 92571-4709
Phone (951) 443-2200

Other identifiers 2

IdentifierTypeStateIssuer
1649384041MedicaidCA
1649384041OtherCAMEDICAL

Other names 1

  • PERRIS FAMILY ROOM CLINIC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1700328929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1688 N PERRIS BLVD",
            "address_2": "SUITE L6-11",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925714709",
            "telephone_number": "951-443-2200",
            "fax_number": "951-443-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1688 N PERRIS BLVD",
            "address_2": "SUITE L6-11",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "92571",
            "telephone_number": "951-443-2200",
            "fax_number": "951-443-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE COUNTY MENTAL HEALTH DEPT.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "WICKI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "BH MFT/SUPERVISOR",
        "authorized_official_telephone_number": "951-443-2200"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649384041",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "1649384041",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PERRIS FAMILY ROOM CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perris, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.