Healthcare Provider Details

I. General information

NPI: 1780590323
Provider Name (Legal Business Name): VIRIDIAN HILLS PSYCHIATRIC & TMS MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 ORANGE TREE LN STE 230
REDLANDS CA
92374-4587
US

IV. Provider business mailing address

1801 ORANGE TREE LN STE 230
REDLANDS CA
92374-4587
US

V. Phone/Fax

Practice location:
  • Phone: 909-769-0611
  • Fax: 909-769-0620
Mailing address:
  • Phone: 909-769-0611
  • Fax: 909-769-0620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL LEE
Title or Position: PSYCHIATRIST
Credential: DO
Phone: 909-769-0611