RADIANT MIND NEURO AND PSYCHOLOGY CLINIC INC
NPI 1629879721
Clinical Neuropsychologist in San Diego, CA

Q: What is Radiant Mind Neuro And Psychology Clinic Inc's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Active since March 24, 2025

402 W BROADWAY STE 400, SAN DIEGO, CA 92101(619) 595-3100 Get Directions Write a Review

NPPES record last updated: August 20, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Radiant Mind Neuro And Psychology Clinic Inc NPPES

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

RADIANT MIND NEURO AND PSYCHOLOGY CLINIC INC (NPI 1629879721) is a healthcare organization registered as a clinical neuropsychologist in San Diego, California and active in the NPI registry since March 2025. The organization maintains a secondary practice location in Las Vegas and lists Melissa Rios, Owner, as its authorized official.

NPPES Registry Identity

NPI1629879721

Entity TypeOrganization

Primary Taxonomy103G00000X

Legal Business NameRADIANT MIND NEURO AND PSYCHOLOGY CLINIC INC

Location Address402 W BROADWAY STE 400San Diego, CA 92101-3554

Mailing Address3225 Mcleod Dr Ste 100Las Vegas, NV 89121-2257 · (424) 248-7139

Phone(619) 595-3100

Organization SubpartNo

Authorized OfficialMelissa RiosOwner · (424) 248-7139

Enumeration DateMarch 24, 2025

Last NPPES UpdateAugust 20, 2025

NPPES CertifiedJuly 21, 2025

✔ NPI 1629879721 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

402 W BROADWAY STE 400, San Diego, CA 92101

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Secondary Practice Location 1

Location 13225 McLeod Dr Ste 100Las Vegas, NV 89121-2257 · Phone (424) 248-7139

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Radiant Mind Neuro And Psychology Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Radiant Mind Neuro And Psychology Clinic Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Melissa Rios, PSYD

Clinical Psychologist

NPI 1093290926

10605 BALBOA BLVD STE 100
Granada Hills, CA 91344

(818) 832-2400

✔ PECOS132 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Radiant Mind Neuro And Psychology Clinic Inc's NPI number?

The NPI number for Radiant Mind Neuro And Psychology Clinic Inc is 1629879721. It was assigned to this organization in the NPPES registry on March 24, 2025.

Where is Radiant Mind Neuro And Psychology Clinic Inc located?

Radiant Mind Neuro And Psychology Clinic Inc is located at 402 W Broadway Ste 400, San Diego, CA 92101. The listed phone number is (619) 595-3100.

What is Radiant Mind Neuro And Psychology Clinic Inc's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Radiant Mind Neuro And Psychology Clinic Inc enrolled in Medicare?

Yes. Radiant Mind Neuro And Psychology Clinic Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Radiant Mind Neuro And Psychology Clinic Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Radiant Mind Neuro And Psychology Clinic Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Radiant Mind Neuro And Psychology Clinic Inc was last updated on August 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.