Individual provider Active NPI

Tristen Ross

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1942970363
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
D6856117 Issued in CA
Practice address
5051 Canyon Crest Dr Ste 204
Riverside, CA 92507-6035
Phone
(951) 682-1488
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X D6856117 CA Primary

Addresses

Primary practice location

5051 Canyon Crest Dr Ste 204
Riverside, CA 92507-6035

Mailing address

5051 Canyon Crest Dr Ste 204
Riverside, CA 92507-6035
Phone (951) 682-1488

Other practice location 1

41760 Ivy St Ste 204
Murrieta, CA 92562-9416
Phone (951) 682-1488

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240416004097 CA Practitioner - Marriage and Family Therapist 5698114163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D6856117CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Psychology Group, a Professional Corporation CurrentSince Apr 1, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 11, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 11, 2024 Accepting new patients

Locations

41760 Ivy St
Ste 204
Murrieta, CA 92562
Phone (951) 682-1488

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

5051 Canyon Crest Dr
Ste 204
Riverside, CA 92507
Phone (951) 682-1488

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Organizations & group practices 4

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": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1942970363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 CANYON CREST DR STE 204",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076035",
            "telephone_number": "951-682-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5051 CANYON CREST DR STE 204",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076035",
            "telephone_number": "951-682-1488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41760 Ivy St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925629416",
            "country_code": "US",
            "telephone_number": "951-682-1488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "TRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2024-10-25",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "D6856117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.