Organization
INLAND PSYCHIATRIC MEDICAL GROUP, INC.
Active
Organization
INLAND PSYCHIATRIC MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER GUTIERREZ (ADMIN PROVIDER RELATIONS)
(909) 289-4075
Entity
Organization
Contact information
Practice address
1140 WILLAGILLESPIE RD STE 44, EUGENE, OR 97401-6727
(541) 735-3241
(541) 735-3455
Mailing address
1140 WILLAGILLESPIE RD STE 44, EUGENE, OR 97401-6727
(541) 735-3241
(541) 735-3455
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649217761
—
CA
Enumeration date
09/17/2025
Last updated
09/17/2025
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