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PITUCK MEDICAL GROUP, INC.
NPI 1255544557
Psychologist - Prescribing (Medical) in Riverside, CA

Active since May 07, 2007
5858 MAGNOLIA AVE STE C, RIVERSIDE, CA 92506(714) 223-0396(714) 223-0397 Get Directions Write a Review

NPPES record last updated: December 4, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pituck Medical Group, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PITUCK MEDICAL GROUP, INC. (NPI 1255544557) is a healthcare organization registered as a prescribing (medical) in Riverside, California and active in the NPI registry since May 2007. The organization lists Michele Severson, Administrator, as its authorized official.

NPPES Registry Identity

NPI1255544557
Entity TypeOrganization
Primary Taxonomy103TP0016X
Legal Business NamePITUCK MEDICAL GROUP, INC.
Location Address5858 MAGNOLIA AVE STE CRiverside, CA 92506-1886
Mailing Address432 Somerset DrPlacentia, CA 92870-2025 · (714) 223-0396 · Fax (714) 223-0397
Phone(714) 223-0396
Fax(714) 223-0397
Organization SubpartNo
Authorized OfficialMichele SeversonAdministrator · (714) 223-0396
Enumeration DateMay 7, 2007
Last NPPES UpdateDecember 4, 2008
✔ NPI 1255544557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Prescribing (Medical)Behavioral Health & Social Service Providers
Taxonomy Code103TP0016X
Definition
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
5858 MAGNOLIA AVE STE C, Riverside, CA 92506
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Other Identifiers 1

Medicare ID-Type UnspecifiedZZZ13983ZCA · Medicare Provider Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pituck Medical Group, Inc.'s NPI number?

The NPI number for Pituck Medical Group, Inc. is 1255544557. It was assigned to this organization in the NPPES registry on May 7, 2007.

Where is Pituck Medical Group, Inc. located?

Pituck Medical Group, Inc. is located at 5858 Magnolia Ave Ste C, Riverside, CA 92506. The listed phone number is (714) 223-0396.

What is Pituck Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Prescribing (Medical), with taxonomy code 103TP0016X.

When was this NPI record last updated?

The NPPES record for Pituck Medical Group, Inc. was last updated on December 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.