Organization
INLAND PSYCHIATRIC MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER GUTIERREZ (PROVIDER RELATIONS)
(909) 289-4075
Entity
Organization
Contact information
Practice address
12377 LEWIS ST STE 105, GARDEN GROVE, CA 92840-4691
(909) 838-0038
(909) 748-5446
Mailing address
1809 W REDLANDS BLVD, REDLANDS, CA 92373-8054
(909) 335-3026
(909) 363-8233
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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