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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
12442 LIMONITE AVE UNIT 104, EASTVALE, CA 91752-2467
(951) 344-4451
(951) 416-2252
Mailing address
1809 W REDLANDS BLVD, REDLANDS, CA 92373-8054
(909) 289-4075
(909) 363-8233

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
2084P0800X
Psychiatry Physician
Primary
363L00000X
Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
02/03/2021
Last updated
02/03/2021
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