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JERRY L. PETTIS VA MEMORIAL HOSPITAL
NPI 1629264775
Psychiatric Hospital in Riverside, CA

Active since September 22, 2007
19845 SAN LUIS REY LN, RIVERSIDE, CA 92508(951) 653-7051 Get Directions Write a Review

NPPES record last updated: September 22, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jerry L. Pettis Va Memorial Hospital NPPES

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

JERRY L. PETTIS VA MEMORIAL HOSPITAL (NPI 1629264775) is a healthcare organization registered as a psychiatric hospital in Riverside, California and active in the NPI registry since September 2007. The organization lists Dean Stordahl, Ceo, as its authorized official.

NPPES Registry Identity

NPI1629264775
Entity TypeOrganization
Primary Taxonomy283Q00000X
Legal Business NameJERRY L. PETTIS VA MEMORIAL HOSPITAL
Location Address19845 SAN LUIS REY LNRiverside, CA 92508-6494
Mailing Address19845 San Luis Rey LnRiverside, CA 92508-6494 · (951) 653-7051
Phone(951) 653-7051
Organization SubpartNo
Authorized OfficialDean StordahlCeo · (909) 825-7084
Enumeration DateSeptember 22, 2007
✔ NPI 1629264775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatric HospitalHospitals
Taxonomy Code283Q00000X
License✔ Licensed in CA · 219193
Definition
An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.
19845 SAN LUIS REY LN, Riverside, CA 92508
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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 Jerry L. Pettis VA Memorial Hospital's NPI number?

The NPI number for Jerry L. Pettis VA Memorial Hospital is 1629264775. It was assigned to this organization in the NPPES registry on September 22, 2007.

Where is Jerry L. Pettis VA Memorial Hospital located?

Jerry L. Pettis VA Memorial Hospital is located at 19845 San Luis Rey Ln, Riverside, CA 92508. The listed phone number is (951) 653-7051.

What is Jerry L. Pettis VA Memorial Hospital's specialty?

The primary specialty registered for this NPI is Psychiatric Hospital with taxonomy code 283Q00000X.

When was this NPI record last updated?

The NPPES record for Jerry L. Pettis VA Memorial Hospital was last updated on September 22, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.