Organization Active NPI

Restore Psychiatry and Wellness, a Professional Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Ontario, CA
National Provider Identifier
1730947276
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
RESTORE PSYCHIATRY AND WELLNESS, A PROFESSIONAL NURSING CORPORATION
Practice address
3200 E Guasti Rd Ste 100
Ontario, CA 91761-8661
Phone
(626) 714-8739
Fax
(866) 740-4693
NPI assigned
Mar 11, 2024
Last updated
May 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Mrs. Marianna Chavez, PMHNPNPI 1932981867
Title
Pmhnp-BC
Phone
(626) 714-8739

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3200 E Guasti Rd Ste 100
Ontario, CA 91761-8661

Mailing address

3200 E Guasti Rd Ste 100
Ontario, CA 91761-8661
Phone (626) 714-8739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250912002030 CA Part B Supplier - Clinic/Group Practice 9739682915 Receives reassigned benefits from 2 practitioners
Practice locations: Ontario, CA; Pasadena, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1710115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1730947276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E GUASTI RD STE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618661",
            "telephone_number": "626-714-8739",
            "fax_number": "866-740-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E GUASTI RD STE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618661",
            "telephone_number": "626-714-8739",
            "fax_number": "866-740-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE PSYCHIATRY AND WELLNESS, A PROFESSIONAL NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-11",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "MARIANNA",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "626-714-8739",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.