NPIMap

Organization Active NPI

Discovery Practice Management, Inc.

Doing business as Discovery Mood & Anxiety Program, San Jacinto (Riverside)

  • Psychiatric Residential Treatment Facility
  • San Jacinto, CA
National Provider Identifier
1801439641
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
DISCOVERY PRACTICE MANAGEMENT, INC.
Doing business as
Discovery Mood & Anxiety Program, San Jacinto (Riverside)
Practice address
1119 W 7TH St
San Jacinto, CA 92582-3856
Phone
(714) 828-1800
Fax
(714) 882-1186
NPI assigned
Oct 24, 2019
Last updated
May 11, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DISCOVERY PRACTICE MANAGEMENT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Magdalen Gustilo
Title
Director of Payer Relations
Phone
(714) 568-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

1119 W 7TH St
San Jacinto, CA 92582-3856

Mailing address

18401 Von Karman Ave Ste 500
Irvine, CA 92612-8531
Phone (714) 828-1800

Other names 1

  • Discovery Mood & Anxiety Program, San Jacinto (Riverside) Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2325274Discovery Practice Management- San Jacinto1119 W 7TH St, San Jacinto, CA 92582Certificate of waiverJun 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Discovery Practice Management Inc105 organizations share this tax ID, including this one
Part of
Discovery Practice Management Inc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1801439641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18401 VON KARMAN AVE STE 500",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128531",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 W 7TH ST",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925823856",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISCOVERY PRACTICE MANAGEMENT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DISCOVERY PRACTICE MANAGEMENT, INC.",
        "enumeration_date": "2019-10-24",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "GUSTILO",
        "authorized_official_first_name": "MAGDALEN",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "714-568-7667"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Discovery Mood & Anxiety Program, San Jacinto (Riverside)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.