Organization
INLAND PSYCHIATRIC MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER GUTIERREZ (CREDENTIALING)
(909) 289-4075
Entity
Organization
Contact information
Practice address
4049 BROCKTON AVE, RIVERSIDE, CA 92501-3440
(951) 300-8124
(951) 262-7702
Mailing address
1809 W REDLANDS BLVD, REDLANDS, CA 92373-8054
(909) 335-3026
(909) 335-3167
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
Enumeration date
09/20/2019
Last updated
12/17/2019
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