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KAISER PERMANENTE
NPI 1265639660
Clinic/Center - Mental Health (Including Community Mental Health Center) in Moreno Valley, CA

Active since June 28, 2007
12815 HEACOCK ST, MORENO VALLEY, CA 92553(051) 601-6174(951) 601-6224 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kaiser Permanente NPPES

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

KAISER PERMANENTE (NPI 1265639660) is a healthcare organization registered as a mental health (including community mental health center) in Moreno Valley, California and active in the NPI registry since June 2007. The organization lists Roger Jackson Melton, Counselor Iii, as its authorized official.

NPPES Registry Identity

NPI1265639660
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameKAISER PERMANENTE
Location Address12815 HEACOCK STMoreno Valley, CA 92553-3116
Mailing Address12815 Heacock StMoreno Valley, CA 92553-3116 · (051) 601-6174 · Fax (951) 601-6224
Phone(051) 601-6174
Fax(951) 601-6224
Organization SubpartNo
Authorized OfficialRoger Jackson MeltonCounselor Iii · (951) 601-6171
Enumeration DateJune 28, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1265639660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
License✔ Licensed in CA · MFC17474
12815 HEACOCK ST, Moreno Valley, CA 92553
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAITLIN THU CHAU M.D.
Family Medicine
12815 HEACOCK ST
MORENO VALLEY, CA 92553
Riverside County (951) 601-6163
MARINOR ANNE MARCELO CONCEPCION DO
Family Medicine
12815 HEACOCK ST
MORENO VALLEY, CA 92553
Riverside County (833) 574-2273
MS. ANA RAYO LMFT
Marriage & Family Therapist
12815 HEACOCK ST
MORENO VALLEY, CA 92553
Riverside County (951) 601-6261
DENENEA CONNER-TILLMAN LCSW
Social Worker
12815 HEACOCK ST
MORENO VALLEY, CA 92553
Riverside County (951) 601-6200
NADINE M HAMMOUD DO, MS
Family Medicine (Addiction Medicine)
12815 HEACOCK ST
MORENO VALLEY, CA 92553
Riverside County (833) 574-2273
VICTORIA LEAH SNYDER LCSW
Social Worker (Clinical)
12815 HEACOCK ST
MORENO VALLEY, CA 92553
Riverside County (951) 601-6174
JESSICA TERRELL MA
Counselor (Addiction (Substance Use Disorder))
12815 HEACOCK ST
MORENO VALLEY, CA 92553
Riverside County (951) 601-6388
HAN-LIN SUNG MD
Family Medicine
12815 HEACOCK ST
MORENO VALLEY, CA 92553
Riverside County (866) 984-7483

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 Kaiser Permanente's NPI number?

The NPI number for Kaiser Permanente is 1265639660. It was assigned to this organization in the NPPES registry on June 28, 2007.

Where is Kaiser Permanente located?

Kaiser Permanente is located at 12815 Heacock St, Moreno Valley, CA 92553. The listed phone number is (051) 601-6174.

What is Kaiser Permanente's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Kaiser Permanente was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.