NPIMap

Organization Active NPI

Quality Life Psychiatric & Psychological Group, Inc.

  • Psychiatry Physician
  • Riverside, CA
National Provider Identifier
1952478596
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A60376 Issued in CA
Legal business name
QUALITY LIFE PSYCHIATRIC & PSYCHOLOGICAL GROUP, INC.
Practice address
6529 Riverside Ave
Suite 133
Riverside, CA 92506-3122
Phone
(951) 684-2627
Fax
(951) 788-5837
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Authorized official

Name
Dr. Richard T Kotomori Jr., M.DNPI 1215059084
Title
Ceo
Phone
(951) 684-2627

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 9

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X PSY19090 CA
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X PSY8086 CA
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY 9633 CA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X MFC 40326 CA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X MFC39054 CA
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X MFT 18385 CA
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X A60376 CA Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X A30827 CA
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X A41330 CA

Addresses

Primary practice location

6529 Riverside Ave
Suite 133
Riverside, CA 92506-3122

Mailing address

6529 Riverside Ave
Suite 133
Riverside, CA 92506-3122
Phone (951) 684-2627

National Provider Directory

National Provider Directory

Locations

6529 Riverside Ave
Ste 133
Riverside, CA 92506
Phone (951) 684-2627

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1952478596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6529 RIVERSIDE AVE",
            "address_2": "SUITE 133",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063122",
            "telephone_number": "951-684-2627",
            "fax_number": "951-788-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6529 RIVERSIDE AVE",
            "address_2": "SUITE 133",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063122",
            "telephone_number": "951-684-2627",
            "fax_number": "951-788-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY LIFE PSYCHIATRIC & PSYCHOLOGICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "KOTOMORI",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-684-2627",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19090",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY8086",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 9633",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 40326",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC39054",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT 18385",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A60376",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A30827",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A41330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.